Athletico Ltd

NPI #1568095602 in Grandview, Missouri

Provider Information

NPI Number: 1568095602
Entity Type: Organization
Organization Name: Athletico Ltd
Primary Specialty: Clinic/Center
Enumeration Date: Feb 18, 2020
Last Updated: Feb 18, 2020

Practice Location

Address: 12404 S US HIGHWAY 71
City: Grandview
State: Missouri
ZIP Code: 64030-1733
Phone: (816) 285-0194

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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