Athletico Ltd
Clinic/Center in Raymore, MO. Organization (NPI-2).
NPI number1295393056
StatusActive
Last updated in NPPESJun 5, 2019
Details
- NPI
- 1295393056
- Entity type
- Organization (NPI-2)
- Legal business name
- Athletico Ltd
- Organization subpart
- No
- Enumeration date
- Jun 5, 2019
- Last updated
- Jun 5, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
| 225100000X | Physical Therapist | – | – | |
| 225X00000X | Occupational Therapist | – | – |
Other names
- Athletico Physical Therapy (Doing Business As)
Practice location
2007 W Foxwood DriveSuite D
Raymore, MO 64083-9589
Phone 816-265-8116 · Fax 816-535-2823
Mailing address
600 Oakmont Ln Ste 600cWestmont, IL 60559-5548
Phone 630-575-1980 · Fax 630-928-5080
Authorized official
Juana Granados
Credentialing Coordinator
6305751980
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