Healthcare Provider Details

I. General information

NPI: 1770091506
Provider Name (Legal Business Name): AGILITY SPINE & SPORTS PHYSICAL THERAPY AND REHABILITATION LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2018
Last Update Date: 01/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7355 S HOUGHTON RD STE 109
TUCSON AZ
85747-9380
US

IV. Provider business mailing address

1777 W SAINT MARYS RD
TUCSON AZ
85745-2687
US

V. Phone/Fax

Practice location:
  • Phone: 520-664-9100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: RICHARD BINSTEIN
Title or Position: VP/AUTHORIZED OFFICIAL
Credential:
Phone: 713-297-7000