| Athletico Physical Therapy | |
|
3156 Telegraph Rd Saint Louis MO 63125-5500 | |
| (314) 894-8616 | |
| (314) 894-8633 |
| Full Name | Athletico Physical Therapy |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 3156 Telegraph Rd, Saint Louis, Missouri |
| 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) 575-6200 | Athletico Physical Therapy 3156 Telegraph Rd Saint Louis MO 63125-5500 Ph: (314) 894-8616 |
| NPI Number | 1114538097 |
|---|---|
| Provider Enumeration Date | 08/13/2020 |
| Last Update Date | 08/13/2020 |
| Certification Date | 08/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114538097 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (NU) | Primary |
| 225100000X | Physical Therapist | (NU) | Secondary |
| 225X00000X | Occupational Therapist | (NU) | Secondary |
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