Organization

Athletico Ltd

Clinic/Center in Florissant, MO(View on Map)

Legal Business Name

Athletico Ltd

NPI Number

1730782111

NPI Type

Organization

Enumeration Date

11/18/2020

Specialties

(Taxonomies)

Code

261Q00000X
225X00000X
225100000X

Primary Taxonomy

Yes
No
No

Contact
Information

Purpose

Mailing
Location

Address

600 OAKMONT LN STE 600C
790 N HIGHWAY 67 ST

City

Westmont
Florissant

State

IL
MO

Postal Code

60559-5548
63031-5108

Country

US
US

Telephone Number

(630) 575-6250
(314) 972-1442

Authorized Official

Name

Juana Granados

Title or Position

CREDENTIALING MANAGER

Telephone Number

(630) 575-1980

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 11/18/2020

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