Organization
AGILE PHYSICAL THERAPY, LLC
Active
Organization
AGILE PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA CATES ALTAMIRANO PT MS CSCS (DIRECTOR)
(205) 969-7887
Entity
Organization
Contact information
Practice address
3125 BLUE LAKE DR, VESTAVIA, AL 35243-2333
(205) 969-7887
(205) 969-7886
Mailing address
3125 BLUE LAKE DR, VESTAVIA, AL 35243-2333
(205) 969-7887
(205) 969-7886
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PTH3294
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265654073
NPI - INDIVIDUAL
AL
01
—
515-92499
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
Enumeration date
08/27/2008
Last updated
12/31/2024
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