Athletico LTD
Organization Active NPI Clinic/Center · Grandville, MI
NPI 1639664857 · NPPES record last updated Mar 9, 2020
Key facts
- NPI
- 1639664857
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- ATHLETICO LTD
- Practice address
- 3819 Rivertown Pkwy SW Ste 100
Grandville, MI 49418 - Phone
- (616) 818-0018
- Fax
- (616) 278-1451
- NPI assigned
- Jun 29, 2018
- Organization subpart
- No
Authorized official
- Name
- Juana Granados
- Title
- Credentialing Manager
- Phone
- (630) 575-1980
Corporate family (same tax ID) 42
National Provider Directory
- Tax ID family
- Athletico LTD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | |||
| Occupational Therapist |
225X00000X | |||
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
3819 Rivertown Pkwy SW Ste 100
Grandville, MI 49418
Mailing address
600 Oakmont LN Ste 600C
Westmont, IL 60559-5548
Phone (630) 575-6200
Other names
- Athletico Physical Therapy
Other providers in Grandville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2020. 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.