| Athletico Ltd | |
|
6511 Bardstown Rd Louisville KY 40291-3042 | |
| (502) 795-1770 | |
| (502) 537-6177 |
| Full Name | Athletico Ltd |
|---|---|
| Speciality | Clinic/center |
| Location | 6511 Bardstown Rd, Louisville, 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 6511 Bardstown Rd Louisville KY 40291-3042 Ph: (502) 795-1770 |
| NPI Number | 1013733286 |
|---|---|
| Provider Enumeration Date | 12/03/2024 |
| Last Update Date | 12/03/2024 |
| Certification Date | 12/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013733286 | 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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