Healthcare Provider Details

I. General information

NPI: 1568856961
Provider Name (Legal Business Name): AGILITAS USA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 11/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5541 GROVE BLVD # C2
HOOVER AL
35226-4600
US

IV. Provider business mailing address

800 CRESCENT CENTRE DR STE 300
FRANKLIN TN
37067-7285
US

V. Phone/Fax

Practice location:
  • Phone: 205-277-6870
  • Fax: 205-277-6871
Mailing address:
  • Phone: 615-373-1350
  • Fax: 615-221-9054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ANDREW LANGE
Title or Position: CFO
Credential:
Phone: 615-373-1350