Athletico Ltd

NPI #1104590496 in Coppell, Texas

Provider Information

NPI Number: 1104590496
Entity Type: Organization
Organization Name: Athletico Ltd
Primary Specialty: Clinic/Center
Enumeration Date: Aug 2, 2021
Last Updated: Aug 2, 2021

Practice Location

Address: 230 N DENTON TAP RD STE 104
City: Coppell
State: Texas
ZIP Code: 75019-2135
Phone: (469) 702-5972

Authorized Official

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

Specialties & Taxonomy Codes

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

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