Athletico Ltd
Clinic/Center in Waco, TX. Organization (NPI-2).
NPI number1639837123
StatusActive
Last updated in NPPESDec 6, 2021
Details
- NPI
- 1639837123
- Entity type
- Organization (NPI-2)
- Legal business name
- Athletico Ltd
- Organization subpart
- No
- Enumeration date
- Dec 2, 2021
- Certification date
- Dec 6, 2021
- Last updated
- Dec 6, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
| 225X00000X | Occupational Therapist | – | – | |
| 225100000X | Physical Therapist | – | – |
Other names
- Athletico Physical Therapy (Doing Business As)
Practice location
1701 Hewitt DrWaco, TX 76712-8660
Phone 254-294-5950 · Fax 254-327-2015
Mailing address
2122 York Rd Ste 300Oak Brook, IL 60523-1925
Phone 630-575-6250 · Fax 630-575-7450
Authorized official
Juana Granados
Credentialing Manager
6305751980
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