Athletico Excel Nebraska, LLC

NPI #1740743327 in Elkhorn, Nebraska

Provider Information

NPI Number: 1740743327
Entity Type: Organization
Organization Name: Athletico Excel Nebraska, LLC
Primary Specialty: Clinic/Center
Enumeration Date: Apr 10, 2019
Last Updated: Apr 10, 2019

Practice Location

Address: 18940 EVANS ST #106
City: Elkhorn
State: Nebraska
ZIP Code: 68022
Phone: (402) 408-0507

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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