Healthcare Provider Details
I. General information
NPI: 1114178357
Provider Name (Legal Business Name): AGILITAS USA INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/07/2008
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2177 NORTHPOINT BLVD STE 101
HIXSON TN
37343-8008
US
IV. Provider business mailing address
800 CRESCENT CENTRE DR STE 300
FRANKLIN TN
37067-7285
US
V. Phone/Fax
- Phone: 423-870-1289
- Fax: 423-877-6861
- Phone: 615-373-1350
- Fax: 615-373-7116
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical 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