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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