Organization · NPI-2

Aegis Group Practice LLC

Physical Therapist · Hollywood, FL

NPI number1518477140

StatusActive

Last updated in NPPESOct 10, 2017

Details

NPI: 1518477140
Entity type: Organization (NPI-2)
Legal business name: Aegis Group Practice LLC
Organization subpart: No
Enumeration date: Oct 10, 2017
Last updated: Oct 10, 2017

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
225100000X	Physical Therapist	–	–	Yes
225X00000X	Occupational Therapist	–	–
235Z00000X	Speech-Language Pathologist,	–	–

Practice location

1200 Arthur St
Hollywood, FL 33019-3118

Phone 800-444-6845 · Fax 844-640-6066

Mailing address

1000 Fianna Way # Md5740
Fort Smith, AR 72919-9008

Phone 479-201-6089

Authorized official

Michael Mcolvin
Vp-Finance
4792012000

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