Healthcare Provider Details

I. General information

NPI: 1295199214
Provider Name (Legal Business Name): AGILITAS USA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2016
Last Update Date: 09/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 BRODIE LN STE 640
SUNSET VALLEY TX
78745-2551
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 512-580-3055
  • Fax: 512-580-3056
Mailing address:
  • Phone: 615-373-1350
  • Fax: 615-221-9054

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