Athletico Ltd
Clinic/Center in Washington, MO. Organization (NPI-2).
NPI number1962005348
StatusActive
Last updated in NPPESNov 18, 2020
Details
- NPI
- 1962005348
- Entity type
- Organization (NPI-2)
- Legal business name
- Athletico Ltd
- Organization subpart
- No
- Enumeration date
- Nov 18, 2020
- Certification date
- Nov 18, 2020
- Last updated
- Nov 18, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
| 225100000X | Physical Therapist | – | – | |
| 225X00000X | Occupational Therapist | – | – |
Other names
- Athletico Physical Therapy (Doing Business As)
Practice location
3101 Recreation Dr Ste 130Washington, MO 63090-6107
Phone 636-239-9979 · Fax 636-239-5442
Mailing address
600 Oakmont Ln Ste 600cWestmont, IL 60559-5548
Phone 630-575-6250 · Fax 630-575-7450
Authorized official
Juana Granados
Credentialing Manager
6305751980
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