Provider Demographics
NPI:1609455443
Name:AGILITAS USA, INC
Entity Type:Organization
Organization Name:AGILITAS USA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-373-1350
Mailing Address - Street 1:PO BOX 306393
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6393
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:
Practice Address - Street 1:3901 FOUNTAINBLUE LANE
Practice Address - Street 2:STE 150
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1389
Practice Address - Country:US
Practice Address - Phone:859-785-4144
Practice Address - Fax:859-787-0288
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AGILITAS USA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy