Organization
ATHLETICO LTD
Active
Other names
ATHETICO PHYSICAL THERAPY
Organization subpart
No
Provider details
NPI number
Authorized official
JUANA GRANADOS (CREDENTIALING MANAGER)
(630) 575-1980
Entity
Organization
Contact information
Practice address
6070 W BELL RD STE A103, GLENDALE, AZ 85308-3774
(602) 782-3965
(602) 715-0079
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 575-1980
(630) 928-5080
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/02/2020
Last updated
01/02/2020
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