Athletico Excel Nebraska, LLC

NPI #1053811802 in Omaha, Nebraska

Provider Information

NPI Number: 1053811802
Entity Type: Organization
Organization Name: Athletico Excel Nebraska, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Feb 19, 2018
Last Updated: Feb 19, 2018

Practice Location

Address: 13110 BIRCH DR STE 164
City: Omaha
State: Nebraska
ZIP Code: 68164-4160
Phone: (402) 496-4666

Authorized Official

Name: JUANA GRANADOS
Title: CREDENTIALING MANAGER
Phone: (630) 575-1980

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X
Occupational Therapist	225X00000X
Physical Therapist	225100000X	Primary

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