Provider Demographics
NPI:1093112989
Name:AGILITY REHAB INC
Entity Type:Organization
Organization Name:AGILITY REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:WUNDERLICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-218-2536
Mailing Address - Street 1:3435 10TH ST N
Mailing Address - Street 2:SUITE 302
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-3815
Mailing Address - Country:US
Mailing Address - Phone:238-218-2536
Mailing Address - Fax:
Practice Address - Street 1:3435 10TH ST N
Practice Address - Street 2:SUITE 302
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3815
Practice Address - Country:US
Practice Address - Phone:238-218-2536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation