Healthcare Provider Details

I. General information

NPI: 1033765631
Provider Name (Legal Business Name): AGILITY NEURO PHYSICAL THERAPY AND WELLNESS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2019
Last Update Date: 08/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6668 OWENS DR FL 2
PLEASANTON CA
94588-3334
US

IV. Provider business mailing address

7449 SUNDROP CT
PLEASANTON CA
94588-4863
US

V. Phone/Fax

Practice location:
  • Phone: 925-460-7220
  • Fax:
Mailing address:
  • Phone: 925-460-7220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. PRITI S CHITALE
Title or Position: CEO
Credential: DPT
Phone: 925-460-7220