Organization
ATHLETICO, LTD
Active
Other names
Athletico Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
TASHEDA BROUGHTON PESC (MANAGER, CREDENTIALING)
(252) 248-3313
Entity
Organization
Contact information
Practice address
630 EUCLID AVE STE 140, LEXINGTON, KY 40502-1997
(859) 303-9980
(859) 303-9830
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(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
08/12/2021
Last updated
12/03/2024
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