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NPI Code Detail

MEDICARE: AGILE PHYSICAL THERAPY INC

MEDICARE: AGILE PHYSICAL THERAPY 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/CenterPT17712CA

General Provider Information

NPI Number : 1659445443
Entity Type Code : Organization
Provider Name (Legal Business Name) : AGILE PHYSICAL THERAPY INC
Provider Business Mailing Address
First Line : 2450 EL CAMINO REAL
Second Line : SUITE 101
City : PALO ALTO
State : CA
Zip : 94306-1706
Country : US
Telephone Number : 650-565-8090
Fax Number : 650-565-8095
Provider Business Practice Location Address
First Line : 2450 EL CAMINO REAL
Second Line : SUITE 101
City : PALO ALTO
State : CA
Zip : 94306-1706
Country : US
Telephone Number : 650-565-8090
Fax Number : 650-565-8095
Authorized Official
Title or Position : BOOKKEEPER
Name : MISS CHRISTINA COLE
Credential :
Telephone Number : 650-565-8090
Provider Enumeration Date : 11/20/2006
Last Update Date : 02/06/2013

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Directions to “AGILE PHYSICAL THERAPY INC ” Practice Location

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