NPI Code Details Logo

NPI 1619884822

NPI 1619884822 : AGILITAS USA, INC : ELIZABETHTOWN, KY

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1619884822
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    AGILITAS USA, INC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/25/2026
-----------------------------------------------------
    Last Update Date     |    08/25/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1513 NORTH DIXIE AVE STE 115 
-----------------------------------------------------
    City                 |    ELIZABETHTOWN
-----------------------------------------------------
    State                |    KY
-----------------------------------------------------
    Zip                  |    42701
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    270-600-1124
-----------------------------------------------------
    Fax                  |    270-600-1125
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1200 CORPORATE DR STE 400 
-----------------------------------------------------
    City                 |    HOOVER
-----------------------------------------------------
    State                |    AL
-----------------------------------------------------
    Zip                  |    35242-5424
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    423-238-7217
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    DIRECTOR OF CREDENTIALING
-----------------------------------------------------
    Name                 |     LAUREN  HILL 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    423-238-7217
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225100000X
-----------------------------------------------------
    Taxonomy Name        |    Physical Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    225X00000X
-----------------------------------------------------
    Taxonomy Name        |    Occupational Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.