Athletico LTD
Organization Active NPI Clinic/Center · Fenton, MI
NPI 1497412043 · NPPES record last updated Nov 18, 2021
Key facts
- NPI
- 1497412043
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- ATHLETICO LTD
- Practice address
- 3401 Owen Rd Ste 400
Fenton, MI 48430-9688 - Phone
- (810) 215-0225
- Fax
- (810) 390-0031
- NPI assigned
- Nov 18, 2021
- Organization subpart
- No
Authorized official
- Name
- Juana Granados
- Title
- Credentialing Manager
- Phone
- (630) 575-1980
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Athleticoltd
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | |||
| Occupational Therapist |
225X00000X | |||
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
3401 Owen Rd Ste 400
Fenton, MI 48430-9688
Mailing address
2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6250
Other names
- Athletico Physical Therapy
Other providers in Fenton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.