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	:	1710628474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGILITAS USA, INC

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	11771 CLAYTON BLVD
Second Line	:
City	:	CLAYTON
State	:	NC
Zip	:	27520-2274
Country	:	US
Telephone Number	:	984-263-0944
Fax Number	:	984-349-5387

Authorized Official
Title or Position	:	DIRECTOR OF CREDENTIALING
Name	:	LAUREN HILL
Credential	:
Telephone Number	:	423-238-7217

Provider Enumeration Date	:	04/06/2022
Last Update Date	:	05/05/2026

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Directions to “AGILITAS USA, INC ” Practice Location

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