Athletico Ltd

NPI #1225608359 in Southlake, Texas

Provider Information

NPI Number: 1225608359
Entity Type: Organization
Organization Name: Athletico Ltd
Primary Specialty: Clinic/Center
Enumeration Date: Jun 30, 2021
Last Updated: Jun 30, 2021

Practice Location

Address: 480 W SOUTHLAKE BLVD STE 111
City: Southlake
State: Texas
ZIP Code: 76092-6167
Phone: (817) 778-9910

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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