Organization
ATHLETICO LTD
Active
Other names
Athletico Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
JUANA GRANADOS (CREDENTIALING MANAGER)
(630) 575-1980
Entity
Organization
Contact information
Practice address
4730 ELMORE AVE UNIT 1, DAVENPORT, IA 52807-3482
(563) 362-3709
(563) 355-9500
Mailing address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 575-1980
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
11/15/2017
Last updated
11/15/2017
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