Healthcare Provider Details

I. General information

NPI: 1104068063
Provider Name (Legal Business Name): AGILITAS USA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2009
Last Update Date: 10/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3810 CENTRAL PIKE STE 102
HERMITAGE TN
37076-3495
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 615-915-5000
  • Fax: 615-915-5002
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 Number7409
License Number StateTN

VIII. Authorized Official

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