NPI 1053811802

Athletico Excel Nebraska, LLC

Organisation Physical Therapist Omaha, NE

Practice location

Address: 13110 Birch Dr STE 164, Omaha, NE 68164-4160
Phone: (402) 496-4666
Fax: (402) 496-1171
Mailing address: 600 Oakmont Ln STE 600c, Westmont, IL 60559-5548

Authorised official

Name: Juana Granados
Title: Credentialing Manager
Phone: (630) 575-1980

Registered specialties (3)

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X

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Occupational Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225X00000X

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Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261Q00000X

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Registry record

NPI: 1053811802
Entity type: Organization
NPI issued: 19 Feb 2018
Record last updated: 19 Feb 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.