Organization · NPI-2
Athletico Ltd
Clinic/Center · Addison, TX
NPI number1376100727
StatusActive
Last updated in NPPESMay 21, 2019
Details
- NPI
- 1376100727
- Entity type
- Organization (NPI-2)
- Legal business name
- Athletico Ltd
- Organization subpart
- No
- Enumeration date
- May 21, 2019
- Last updated
- May 21, 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
14380 Marsh Ln # 120Addison, TX 75001-3879
Phone 972-942-2097 · Fax 972-843-9217
Mailing address
600 Oakmont Ln Ste 600cWestmont, IL 60559-5548
Phone 630-575-6200 · Fax 630-928-5080
Authorized official
Juana Granados
Credentialing Manager
6305751980
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