Athletico Ltd

NPI #1750032900 in Independence, Missouri

Provider Information

NPI Number: 1750032900
Entity Type: Organization
Organization Name: Athletico Ltd
Primary Specialty: Clinic/Center
Enumeration Date: Jan 10, 2022
Last Updated: Jan 10, 2022

Practice Location

Address: 4600 S NOLAND RD STE A
City: Independence
State: Missouri
ZIP Code: 64055-4797
Phone: (816) 313-2220

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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