Athletico Ltd
Clinic/Center in Lexington, KY. Organization (NPI-2).
NPI number1407672660
StatusActive
Last updated in NPPESDec 3, 2024
Details
- NPI
- 1407672660
- Entity type
- Organization (NPI-2)
- Legal business name
- Athletico Ltd
- Organization subpart
- No
- Enumeration date
- Dec 3, 2024
- Certification date
- Dec 3, 2024
- Last updated
- Dec 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
| 225100000X | Physical Therapist | – | – | |
| 225X00000X | Occupational Therapist | – | – |
Practice location
2703 Richmond Rd Ste 130Lexington, KY 40509-2743
Phone 859-687-6815 · Fax 859-788-5258
Mailing address
2122 York Rd Ste 300Oak Brook, IL 60523-1925
Phone 252-248-3313 · Fax 410-678-4878
Authorized official
Tasheda Broughton
Manager, Credentialing
2522483313
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