Organization · NPI-2

Athletico Ltd

Clinic/Center · Waco, TX

NPI number1386301083
StatusActive
Last updated in NPPESNov 17, 2021

Details

NPI
1386301083
Entity type
Organization (NPI-2)
Legal business name
Athletico Ltd
Organization subpart
No
Enumeration date
Nov 17, 2021
Certification date
Nov 17, 2021
Last updated
Nov 17, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes
225100000X Physical Therapist––
225X00000X Occupational Therapist––

Other names

  • Athletico Physical Therapy (Doing Business As)

Practice location

1011 S 10th St Ste 130
Waco, TX 76706-1384

Phone 254-294-5924 · Fax 254-327-2014

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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