Organization · NPI-2

Athletico Ltd

Clinic/Center · Rockwall, TX

NPI number1346992575

StatusActive

Last updated in NPPESJan 19, 2022

Details

NPI: 1346992575
Entity type: Organization (NPI-2)
Legal business name: Athletico Ltd
Organization subpart: No
Enumeration date: Jan 19, 2022
Certification date: Jan 19, 2022
Last updated: Jan 19, 2022

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

2930 Ridge Rd
Rockwall, TX 75032-5803

Phone 469-887-1070 · Fax 469-769-3001

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925

Phone 630-575-6250 · Fax 630-575-7450

Authorized official

Juana Granados
Credentialing Manager
6305751980

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