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General NPI Number Information
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NPI Number | 1023575487
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Entity Type | Organization
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Legal Business Name | AGILITAS USA INC.
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Dates
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Enumeration Date | 02/21/2019
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 950 W UNIVERSITY AVE STE 207
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City | GEORGETOWN
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State | TX
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Zip | 78626-6508
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Country | US
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Telephone | 512-982-3363
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Fax | 512-961-8892
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Provider Business Mailing Address
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Address Line | 800 CRESCENT CENTRE DR STE 300
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City | FRANKLIN
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State | TN
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Zip | 37067-7285
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Country | US
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Telephone | 615-373-1350
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Fax | 615-221-9054
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | MELISSA GILMORE
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Credential |
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Telephone | 615-465-0922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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