Provider Demographics
NPI:1609118561
Name:AGILITY PHYSICAL THERAPY AND WELLNESS LLC
Entity type:Organization
Organization Name:AGILITY PHYSICAL THERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMBIKA
Authorized Official - Middle Name:D
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:609-632-2129
Mailing Address - Street 1:572 US HIGHWAY 130
Mailing Address - Street 2:SUITE 4
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-2600
Mailing Address - Country:US
Mailing Address - Phone:609-632-2129
Mailing Address - Fax:609-632-2131
Practice Address - Street 1:572 US HIGHWAY 130
Practice Address - Street 2:SUITE 4
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-2600
Practice Address - Country:US
Practice Address - Phone:609-632-2129
Practice Address - Fax:609-632-2131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-19
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty