Athletico Ltd

NPI #1780162305 in Taylor, Michigan

Provider Information

NPI Number: 1780162305
Entity Type: Organization
Organization Name: Athletico Ltd
Primary Specialty: Clinic/Center
Enumeration Date: Aug 6, 2018
Last Updated: Mar 9, 2020

Practice Location

Address: 22606 NORTHLINE RD
City: Taylor
State: Michigan
ZIP Code: 48180-4660
Phone: (734) 720-8797

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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