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NPI Code Detail

MEDICARE: AGILITAS USA INC

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
1261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1447685045
Entity Type Code : Organization
Provider Name (Legal Business Name) : AGILITAS USA INC
Provider Business Mailing Address
First Line : 800 CRESCENT CENTRE DR STE 300
Second Line :
City : FRANKLIN
State : TN
Zip : 37067-7285
Country : US
Telephone Number : 615-373-1350
Fax Number : 615-373-7116
Provider Business Practice Location Address
First Line : 2011 GRINSTEAD DR UNIT 101
Second Line :
City : LOUISVILLE
State : KY
Zip : 40204-1296
Country : US
Telephone Number : 502-813-7838
Fax Number : 502-813-7839
Authorized Official
Title or Position : CFO
Name : ANDREW LANGE
Credential :
Telephone Number : 615-373-1350
Provider Enumeration Date : 09/13/2013
Last Update Date : 11/16/2019

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