Athletico Ltd

NPI #1336646124 in East Lansing, Michigan

Provider Information

NPI Number: 1336646124
Entity Type: Organization
Organization Name: Athletico Ltd
Primary Specialty: Clinic/Center
Enumeration Date: Apr 9, 2018
Last Updated: Apr 12, 2022

Practice Location

Address: 1595 W LAKE LANSING RD STE 130
City: East Lansing
State: Michigan
ZIP Code: 48823-1317
Phone: (517) 333-6692

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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