Organization
EASTERN IOWA THERAPEUTICS P.C.
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
155 CEDAR RIVER PARKWAY, SUITE 101, WAVERLY, IA 50677
(319) 483-0002
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 590-4029
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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