| Athletico Physical Therapy | |
|
603 S Bishop Ave Ste B Rolla MO 65401-4320 | |
| (573) 202-6537 | |
| (573) 426-7001 |
| Full Name | Athletico Physical Therapy |
|---|---|
| Speciality | Clinic/center |
| Location | 603 S Bishop Ave Ste B, Rolla, Missouri |
| Authorized Official Name and Position | Juana Granados (CREDENTIALING MANANGER) |
| 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) 575-6250 | Athletico Physical Therapy 603 S Bishop Ave Ste B Rolla MO 65401-4320 Ph: (573) 202-6537 |
| NPI Number | 1629691639 |
|---|---|
| Provider Enumeration Date | 05/26/2020 |
| Last Update Date | 05/26/2020 |
| Certification Date | 05/26/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629691639 | 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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