Healthcare Provider Details

I. General information

NPI: 1104970979
Provider Name (Legal Business Name): AGILITAS USA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 10/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 W BADDOUR PKWY STE 120
LEBANON TN
37087-1510
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 615-443-9036
  • Fax: 615-443-9037
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