Healthcare Provider Details

I. General information

NPI: 1114390606
Provider Name (Legal Business Name): AGILITAS USA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2015
Last Update Date: 01/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 N MARKET ST SUITE 102
CHATTANOOGA TN
37405-4438
US

IV. Provider business mailing address

800 CRESCENT CENTRE DR SUITE 600
FRANKLIN TN
37067-7269
US

V. Phone/Fax

Practice location:
  • Phone: 423-664-1070
  • Fax: 423-664-1071
Mailing address:
  • Phone: 615-373-1350
  • Fax: 615-373-7116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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