| Athletico Physical Therapy | |
|
2807 Lake Michigan Dr Nw Ste 1 Grand Rapids MI 49504-5856 | |
| (616) 649-1577 | |
| (616) 228-9578 |
| Full Name | Athletico Physical Therapy |
|---|---|
| Speciality | Clinic/center |
| Location | 2807 Lake Michigan Dr Nw Ste 1, Grand Rapids, Michigan |
| Authorized Official Name and Position | Juana Granados (CREDENTIALING MANAGER) |
| Authorized Official Contact | 6305751980 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Athletico Physical Therapy 600 Oakmont Ln Ste 600c Westmont IL 60559-5548 Ph: (630) 575-1980 | Athletico Physical Therapy 2807 Lake Michigan Dr Nw Ste 1 Grand Rapids MI 49504-5856 Ph: (616) 649-1577 |
| NPI Number | 1609388800 |
|---|---|
| Provider Enumeration Date | 10/27/2017 |
| Last Update Date | 03/09/2020 |
| Certification Date | 03/09/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609388800 | 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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