Organization · NPI-2

Aegis Group Practice LLC

Physical Therapist · Collierville, TN

NPI number1265218614

StatusActive

Last updated in NPPESSep 1, 2023

Details

NPI: 1265218614
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
235Z00000X	Speech-Language Pathologist,	–	–
225X00000X	Occupational Therapist	–	–

Practice location

15 Schilling Bend Cmn
Collierville, TN 38017-7183

Phone 800-444-6845

Mailing address

4933 Old Greenwood Rd
Fort Smith, AR 72903-6906

Authorized official

Tracy Mccall
Contract Specialist
4792016091

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.