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	225100000X	Physical Therapist
2	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1619686920
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	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 SAINT JOSEPH CT STE 310
Second Line	:
City	:	LIBERTY HILL
State	:	TX
Zip	:	78642-3404
Country	:	US
Telephone Number	:	737-843-4195
Fax Number	:	512-982-1199

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

Provider Enumeration Date	:	11/16/2022
Last Update Date	:	05/01/2023

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Directions to “AGILITAS USA INC ” Practice Location

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