Athletico Ltd

NPI #1992401574 in South Lyon, Michigan

Provider Information

NPI Number: 1992401574
Entity Type: Organization
Organization Name: Athletico Ltd
Primary Specialty: Clinic/Center
Enumeration Date: Feb 6, 2023
Last Updated: Feb 6, 2023

Practice Location

Address: 22179 PONTIAC TRL STE C
City: South Lyon
State: Michigan
ZIP Code: 48178-1638
Phone: (248) 587-7843

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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