Aegis Group Practice LLC
Physical Therapist in Collierville, TN. Organization (NPI-2).
NPI number1063298412
StatusActive
Last updated in NPPESSep 1, 2023
Details
- NPI
- 1063298412
- Entity type
- Organization (NPI-2)
- Legal business name
- Aegis Group Practice LLC
- Organization subpart
- No
- Enumeration date
- Sep 1, 2023
- Certification date
- Aug 31, 2023
- Last updated
- Sep 1, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
| 225X00000X | Occupational Therapist | – | – | |
| 235Z00000X | Speech-Language Pathologist, | – | – |
Practice location
601 Wolf River BlvdCollierville, TN 38017-6600
Phone 800-444-6845
Mailing address
4933 Old Greenwood RdFort Smith, AR 72903-6906
Authorized official
Tracy Mccall
Contract Specialist
4792016091
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