Athletico Ltd

NPI #1861095010 in Mukwonago, Wisconsin

Provider Information

NPI Number: 1861095010
Entity Type: Organization
Organization Name: Athletico Ltd
Primary Specialty: Clinic/Center
Enumeration Date: Nov 19, 2020
Last Updated: Nov 19, 2020

Practice Location

Address: 1231 S ROCHESTER ST STE 210
City: Mukwonago
State: Wisconsin
ZIP Code: 53149-9032
Phone: (262) 710-9100

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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