Organization · NPI-2

Aegis Group Practice LLC

Physical Therapist · Saint Louis, MO

NPI number1265337067
StatusActive
Last updated in NPPESOct 12, 2026

Details

NPI
1265337067
Entity type
Organization (NPI-2)
Legal business name
Aegis Group Practice LLC
Organization subpart
No
Enumeration date
Oct 12, 2026
Certification date
Oct 12, 2026
Last updated
Oct 12, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist––Yes
225X00000X Occupational Therapist––
235Z00000X Speech-Language Pathologist,––

Practice location

450 N Lindbergh Blvd
Saint Louis, MO 63141-7814

Phone 479-201-6037

Mailing address

4933 Old Greenwood Rd
Fort Smith, AR 72903-6906

Phone 479-201-6037

Authorized official

Terry Lamb
Credentialing
4792016037

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