Organization · NPI-2

Athletico, Ltd

Clinic/Center · Chesapeake, VA

NPI number1699448654
StatusActive
Last updated in NPPESJul 27, 2021

Details

NPI
1699448654
Entity type
Organization (NPI-2)
Legal business name
Athletico, Ltd
Organization subpart
No
Enumeration date
Jul 27, 2021
Certification date
Jul 27, 2021
Last updated
Jul 27, 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

1412 Greenbrier Pkwy Ste 134
Chesapeake, VA 23320-2834

Phone 757-609-0600 · Fax 757-290-6431

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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