Athletico, Ltd

NPI #1932713146 in Sussex, Wisconsin

Provider Information

NPI Number: 1932713146
Entity Type: Organization
Organization Name: Athletico, Ltd
Subpart: Yes (part of a larger organization)
Parent Organization: ATHLETICO, LTD
Primary Specialty: Clinic/Center - Multi-Specialty
Enumeration Date: Sep 4, 2020
Last Updated: Sep 4, 2020

Practice Location

Address: N63W23675 MAIN ST
City: Sussex
State: Wisconsin
ZIP Code: 53089
Phone: (262) 342-0062

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 - Multi-Specialty — Multi-Specialty	261QM1300X	Primary

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