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Agile Physical Therapy, LLC

Details

Name: Agile Physical Therapy, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 01 Nov 2007 (17 years ago) (Companies founded in November 2007)
Entity Number: 000-411-849
Register Number: 000411849
ZIP code: 36104 (Companies in Montgomery, 36104)
County: Montgomery
Place of Formation: Montgomery County
Principal Address: MONTGOMERY, AL
Registered Office Street Address: 2 NORTH JACKSON STREET SUITE 605MONTGOMERY, AL 36104

Activities HEALTH CARE SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1154578524 2008-08-27 2008-09-08 3419 COLONNADE PKWY STE 100, BIRMINGHAM, AL, 352433337, US 3419 COLONNADE PKWY STE 100, BIRMINGHAM, AL, 352433337, US

Contacts
Phone +1 205-969-7887
Fax 2059697886

Authorized person
Name MRS. LISA CATES ALTAMIRANO
Role DIRECTOR
Phone 2059697887

Taxonomy
Taxonomy Code 261QP2000X - Physical Therapy Clinic/Center
License Number PTH3294
State AL
Is Primary Yes

Other Provider Identifiers
Issuer NPI - INDIVIDUAL
Number 1265654073
State AL
Issuer BLUE CROSS BLUE SHIELD OF ALABAMA
Number 515-92499
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AGILE PHYSICAL THERAPY 401K PLAN 2023 352316740 2024-09-10 AGILE PHYSICAL THERAPY, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621340
Sponsor’s telephone number 2059697887
Plan sponsor’s address 3125 BLUE LAKE DRIVE, VESTAVIA, AL, 35243
AGILE PHYSICAL THERAPY 401K PLAN 2022 352316740 2023-08-30 AGILE PHYSICAL THERAPY, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621340
Sponsor’s telephone number 2059697887
Plan sponsor’s address 3125 BLUE LAKE DRIVE, VESTAVIA, AL, 35243
AGILE PHYSICAL THERAPY 401K PLAN 2021 352316740 2022-07-12 AGILE PHYSICAL THERAPY, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621340
Sponsor’s telephone number 2059697887
Plan sponsor’s address 3125 BLUE LAKE DRIVE, VESTAVIA, AL, 35243

Signature of
Role Plan administrator
Date 2022-07-12
Name of individual signing LISA ALTAMIRANO
AGILE PHYSICAL THERAPY 401K PLAN 2020 352316740 2021-05-11 AGILE PHYSICAL THERAPY, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621340
Sponsor’s telephone number 2059697887
Plan sponsor’s address 3125 BLUE LAKE DRIVE, VESTAVIA, AL, 35243

Signature of
Role Plan administrator
Date 2021-05-11
Name of individual signing LISA ALTAMIRANO
AGILE PHYSICAL THERAPY 401K PLAN 2019 352316740 2020-10-06 AGILE PHYSICAL THERAPY, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621340
Sponsor’s telephone number 2059697887
Plan sponsor’s address 3125 BLUE LAKE DRIVE, VESTAVIA, AL, 35243

Signature of
Role Plan administrator
Date 2020-10-06
Name of individual signing LISA ALTAMIRANO
AGILE PHYSICAL THERAPY 401K PLAN 2018 352316740 2019-07-19 AGILE PHYSICAL THERAPY, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621610
Sponsor’s telephone number 2059697887
Plan sponsor’s address 3125 BLUE LAKE DRIVE, VESTAVIA, AL, 35243

Signature of
Role Plan administrator
Date 2019-07-19
Name of individual signing LISA ALTAMIRANO
AGILE PHYSICAL THERAPY 401K PLAN 2017 352316740 2018-10-11 AGILE PHYSICAL THERAPY, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621610
Sponsor’s telephone number 2059697887
Plan sponsor’s address 3125 BLUE LAKE DRIVE, VESTAVIA, AL, 35243

Agent

Name Role
NATIONAL REGISTERED AGENTS INC Agent

Member

Name Role
ALTAMIRANO, LISA C Member
ALTAMIRANO, VICTOR NORMAN Member

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MONTGOMERY, AL

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2 NORTH JACKSON STREET SUITE 605MONTGOMERY, AL 36104

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Date of last update: 13 Aug 2024

Sources: Alabama Secretary of State

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