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General NPI Number Information
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NPI Number | 1669635793
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Entity Type | Individual
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Provider Name | CARL ANDREW AGNE MPT
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Gender | Male
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 200 SPRINGS RD
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City | BEDFORD
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State | MA
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Zip | 01730-1198
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Country | US
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Telephone | 781-687-3059
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Fax |
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Provider Business Mailing Address
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Address Line | 10 CARLEY RD
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City | LEXINGTON
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State | MA
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Zip | 02421-4302
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Country | US
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Telephone | 781-861-0677
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 15736
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License Number State | MA
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