Athletico Ltd

NPI #1215530084 in La Porte, Indiana

Provider Information

NPI Number: 1215530084
Entity Type: Organization
Organization Name: Athletico Ltd
Primary Specialty: Clinic/Center
Enumeration Date: Nov 16, 2020
Last Updated: Nov 16, 2020

Practice Location

Address: 2338 N US HIGHWAY 35
City: La Porte
State: Indiana
ZIP Code: 46350-8380
Phone: (219) 325-0060

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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