Provider Demographics
NPI:1033765631
Name:AGILITY NEURO PHYSICAL THERAPY AND WELLNESS INC.
Entity Type:Organization
Organization Name:AGILITY NEURO PHYSICAL THERAPY AND WELLNESS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PRITI
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHITALE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:925-460-7220
Mailing Address - Street 1:7449 SUNDROP CT
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4863
Mailing Address - Country:US
Mailing Address - Phone:925-460-7220
Mailing Address - Fax:
Practice Address - Street 1:6668 OWENS DR FL 2
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3334
Practice Address - Country:US
Practice Address - Phone:925-460-7220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-11
Last Update Date:2019-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty