Organization · NPI-2

Athletico Ltd

Clinic/Center · Peoria, AZ

NPI number1679245385
StatusActive
Last updated in NPPESOct 26, 2021

Details

NPI
1679245385
Entity type
Organization (NPI-2)
Legal business name
Athletico Ltd
Organization subpart
No
Enumeration date
Sep 30, 2021
Certification date
Oct 26, 2021
Last updated
Oct 26, 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

24737 N Lake Pleasant Pkwy Ste 106
Peoria, AZ 85383-1569

Phone 623-289-3200 · Fax 623-223-5072

Mailing address

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

Phone 630-575-1980 · Fax 630-928-5080

Authorized official

Juana Granados
Credentialing Manager
6305751980

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