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PROREHAB PC
NPI 1104467547
Clinic/Center in Perryville, MO

Active since October 07, 2019
1418 W SAINT JOSEPH ST STE 170, PERRYVILLE, MO 63775(573) 513-8170 Get Directions Write a Review

NPPES record last updated: October 7, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Prorehab Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROREHAB PC (NPI 1104467547), doing business as Athletico Physical Therapy, is a healthcare organization registered as a clinic/center in Perryville, Missouri and active in the NPI registry since October 2019. The organization lists Juana Granados, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1104467547
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NamePROREHAB PC
Location Address1418 W SAINT JOSEPH ST STE 170Perryville, MO 63775-1678
Mailing Address600 Oakmont Ln Ste 600cWestmont, IL 60559-5548 · (630) 575-6200
Phone(573) 513-8170
Organization SubpartNo
Authorized OfficialJuana GranadosCredentialing Manager · (630) 575-1980
Enumeration DateOctober 7, 2019
✔ NPI 1104467547 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Also ListedPhysical TherapistTaxonomy 225100000X
Also ListedOccupational TherapistTaxonomy 225X00000X
1418 W SAINT JOSEPH ST STE 170, Perryville, MO 63775
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Other Names 1

Doing Business AsAthletico Physical Therapy

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prorehab PC's NPI number?

The NPI number for Prorehab PC is 1104467547. It was assigned to this organization in the NPPES registry on October 7, 2019. The provider is doing business as Athletico Physical Therapy.

Where is Prorehab PC located?

Prorehab PC is located at 1418 W Saint Joseph St Ste 170, Perryville, MO 63775. The listed phone number is (573) 513-8170.

What is Prorehab PC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Prorehab PC was last updated on October 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.