Athletico Ltd
NPI #1619570074 in Edwardsville, Illinois
Provider Information
- NPI Number
- 1619570074
- Entity Type
- Organization
- Organization Name
- Athletico Ltd
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Nov 18, 2020
- Last Updated
- Nov 18, 2020
Practice Location
- Address
- 1047 CENTURY DR
- City
- Edwardsville
- State
- Illinois
- ZIP Code
- 62025-3772
- Phone
- (618) 307-3434
Authorized Official
- Name
- JUANA GRANADOS
- Title
- CREDENTIALING MANAGER
- Phone
- (630) 575-1980
Specialties & Taxonomy Codes
| Specialty |
|---|
| Occupational Therapist |
| Physical Therapist |
| Clinic/Center |
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