1477607208 NPI number — AGILITAS USA, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477607208 NPI number — AGILITAS USA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AGILITAS USA, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
RESULTS PHYSIOTHERAPY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477607208
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/04/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 CRESCENT CENTRE DR STE 600
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37067-7286
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-373-1350
Provider Business Mailing Address Fax Number:
615-221-9054

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
172 W UNIVERSITY PKWY
Provider Second Line Business Practice Location Address:
STE. C
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38305-1622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
731-512-0540
Provider Business Practice Location Address Fax Number:
731-512-0560
Provider Enumeration Date:
01/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LANGE
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
615-373-1350

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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