Organization · NPI-2
Aegis Group Practice LLC
Occupational Therapist · Marietta, GA
NPI number1538540893
StatusActive
Last updated in NPPESJun 12, 2015
Details
- NPI
- 1538540893
- Entity type
- Organization (NPI-2)
- Legal business name
- Aegis Group Practice LLC
- Organization subpart
- Yes
- Enumeration date
- Jun 12, 2015
- Last updated
- Jun 12, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | – | – | Yes |
| 225100000X | Physical Therapist | – | – | |
| 235Z00000X | Speech-Language Pathologist, | – | – |
Practice location
895 Canton Rd NeBldg 200, Ste 100
Marietta, GA 30060-8934
Phone 877-823-8375
Mailing address
1000 Fianna WayMail Drop 4840
Fort Smith, AR 72919-4840
Phone 479-201-4840
Authorized official
Holly Rasmussen-Jones
Secretary
4792014835
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