| Athletico Ltd | |
|
129 Towne Center Dr Ste 129 Lexington KY 40511-2027 | |
| (859) 977-9499 | |
| (859) 963-3005 |
| Full Name | Athletico Ltd |
|---|---|
| Speciality | Clinic/center |
| Location | 129 Towne Center Dr Ste 129, Lexington, Kentucky |
| Authorized Official Name and Position | Tasheda Broughton (MANAGER, CREDENTIALING) |
| Authorized Official Contact | 2522483313 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Athletico Ltd 2122 York Rd Ste 300 Oak Brook IL 60523-1925 Ph: (252) 248-3313 | Athletico Ltd 129 Towne Center Dr Ste 129 Lexington KY 40511-2027 Ph: (859) 977-9499 |
| NPI Number | 1265258420 |
|---|---|
| Provider Enumeration Date | 12/03/2024 |
| Last Update Date | 12/03/2024 |
| Certification Date | 12/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265258420 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
| 225100000X | Physical Therapist | (NU) | Secondary |
| 225X00000X | Occupational Therapist | (NU) | Secondary |
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