Athletico Ltd

NPI #1124672977 in Grafton, Wisconsin

Provider Information

NPI Number: 1124672977
Entity Type: Organization
Organization Name: Athletico Ltd
Primary Specialty: Clinic/Center
Enumeration Date: Jul 30, 2019
Last Updated: Jul 30, 2019

Practice Location

Address: 2225 WISCONSIN AVE STE 100
City: Grafton
State: Wisconsin
ZIP Code: 53024-2608
Phone: (262) 474-0063

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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