Agility Lab Services
Clinic/Center in Indianapolis, IN. Organization (NPI-2).
NPI number1750042388
StatusActive
Last updated in NPPESMar 15, 2022
Details
- NPI
- 1750042388
- Entity type
- Organization (NPI-2)
- Legal business name
- Agility Lab Services
- Organization subpart
- No
- Enumeration date
- Jan 5, 2022
- Certification date
- Mar 15, 2022
- Last updated
- Mar 15, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
540 W 65th StIndianapolis, IN 46260-4604
Phone 317-991-8054
Mailing address
540 W 65th StIndianapolis, IN 46260-4604
Phone 317-991-8054
Authorized official
Courtney Fleming
Owner
3179918054
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