Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Agave Physical Therapy LLC

Organization Physical Therapy Clinic/Center · NPI 1720521040

Agave Physical Therapy LLC is a Physical Therapy Clinic/Center in Lake Havasu City, Arizona. Registered with an NPI since 2016.

In the registry since
2016
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

191 Swanson Ave #102
Lake Havasu City, AZ 86403-6699
Phone: (928) 855-7880
Fax: (928) 855-7881
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Clinic/Center (primary) Taxonomy 261QP2000X

Record details

NPI number1720521040
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brett Qualls — Owner · (928) 855-7880
NPI enumeratedNovember 18, 2016
Last updated in NPPESDecember 13, 2016
Mailing address191 Swanson Ave, 102, Lake Havasu City, AZ 86403-6699

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