Provider Demographics
NPI:1295322535
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 1:181 HUGHES RD STE 1B
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-1146
Practice Address - Country:US
Practice Address - Phone:256-850-1155
Practice Address - Fax:256-513-7833
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AGILITAS USA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy