Aegis Group Practice LLC
Physical Therapist in Niceville, FL. Organization (NPI-2).
NPI number1669976015
StatusActive
Last updated in NPPESMar 21, 2018
Details
- NPI
- 1669976015
- Entity type
- Organization (NPI-2)
- Legal business name
- Aegis Group Practice LLC
- Organization subpart
- No
- Enumeration date
- Mar 21, 2018
- Last updated
- Mar 21, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
| 225X00000X | Occupational Therapist | – | – | |
| 235Z00000X | Speech-Language Pathologist, | – | – |
Practice location
2300 Partin Dr NNiceville, FL 32578-1538
Phone 800-444-6845
Mailing address
1000 Fianna WayFort Smith, AR 72919-9008
Phone 479-201-6089
Authorized official
Michael McOlvin
Vp-Finance
4792012000
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