Athletico Ltd

NPI #1760950489 in New Berlin, Wisconsin

Provider Information

NPI Number: 1760950489
Entity Type: Organization
Organization Name: Athletico Ltd
Primary Specialty: Physical Therapist
Enumeration Date: Nov 12, 2018
Last Updated: Nov 12, 2018

Practice Location

Address: 15175 W NATIONAL AVE
City: New Berlin
State: Wisconsin
ZIP Code: 53151-5150
Phone: (262) 649-2135

Authorized Official

Name: JUANA GRANADOS
Title: CREDENTIALING MANAGER
Phone: (630) 575-1980

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Clinic/Center	261Q00000X
Physical Therapist	225100000X	Primary

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