Graduated: 1990
NPI: 1518140888
Practice Locations (2)
ATHLETICO LTD
4179 LINDELL BLVD
SAINT LOUIS, MO 631082913
3149440494
ATHLETICO LTD
1832 WENTZVILLE PKWY
WENTZVILLE, MO 633853817
6363277110
Source: CMS National Downloadable File, September 2026.