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Aegis Group Practice LLC

Physical Therapist in Onalaska, WI. Organization (NPI-2).

NPI number1306336565
StatusActive
Last updated in NPPESSep 15, 2022

Details

NPI
1306336565
Entity type
Organization (NPI-2)
Legal business name
Aegis Group Practice LLC
Organization subpart
No
Enumeration date
May 14, 2018
Certification date
Sep 15, 2022
Last updated
Sep 15, 2022

Taxonomy and licenses

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

Practice location

861 Critter Ct
Onalaska, WI 54650-8689

Phone 800-444-6845 · Fax 479-478-2852

Mailing address

2601 Network Blvd Ste 102
Frisco, TX 75034-9092

Phone 972-372-6779 · Fax 479-668-0872

Authorized official

Misty S Wilson
Contract/Credentialing
9723726779

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