Organization · NPI-2

Aegis Group Practice LLC

Physical Therapist · Collierville, TN

NPI number1326824780

StatusActive

Last updated in NPPESSep 1, 2023

Details

NPI: 1326824780
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

1368 Wolf River Blvd
Collierville, TN 38017-8687

Phone 800-444-6845

Mailing address

4933 Old Greenwood Rd
Fort Smith, AR 72903-6906

Authorized official

Tracy Mccall
Contract Specialist
4792016091

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