| Athletico Physical Therapy | |
|
1321 Interstate Pkwy Augusta GA 30909-5626 | |
| (706) 945-0810 | |
| (706) 945-0821 |
| Full Name | Athletico Physical Therapy |
|---|---|
| Speciality | Physical Therapist |
| Location | 1321 Interstate Pkwy, Augusta, Georgia |
| Authorized Official Name and Position | Juana Granados (CREDENTIALING MANAGER) |
| Authorized Official Contact | 6305751980 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Athletico Physical Therapy 2122 York Rd Ste 300 Oak Brook IL 60523-1925 Ph: (630) 575-1980 | Athletico Physical Therapy 1321 Interstate Pkwy Augusta GA 30909-5626 Ph: (706) 945-0810 |
| NPI Number | 1679286934 |
|---|---|
| Provider Enumeration Date | 01/03/2023 |
| Last Update Date | 01/03/2023 |
| Certification Date | 01/03/2023 |
| Medicare PECOS PAC ID | 6002812401 |
|---|---|
| Medicare Enrollment ID | O20070509000651 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679286934 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Secondary |
| 225100000X | Physical Therapist | (NU) | Primary |
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