MEDICARE: AGILITAS USA, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1306574249
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGILITAS USA, INC

Provider Business Mailing Address
First Line	:	PO BOX 306393
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37230-6393
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:	423-238-3473

Provider Business Practice Location Address
First Line	:	3849 DAYTON BLVD STE 109
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37415-4044
Country	:	US
Telephone Number	:	423-877-5817
Fax Number	:	423-877-7170

Authorized Official
Title or Position	:	CFO
Name	:	THOMAS BRYAN BARGANIER
Credential	:
Telephone Number	:	205-536-7602

Provider Enumeration Date	:	08/09/2022
Last Update Date	:	08/09/2022

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Directions to “AGILITAS USA, INC ” Practice Location

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