Organization · NPI-2

Athletico Ltd

Clinic/Center · Independence, MO

NPI number1750032900
StatusActive
Last updated in NPPESJan 10, 2022

Details

NPI
1750032900
Entity type
Organization (NPI-2)
Legal business name
Athletico Ltd
Organization subpart
No
Enumeration date
Jan 10, 2022
Certification date
Jan 10, 2022
Last updated
Jan 10, 2022

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

4600 S Noland Rd Ste A
Independence, MO 64055-4797

Phone 816-313-2220 · Fax 816-897-2390

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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