Aegis Group Practice LLC

NPI #1164121257 in Fall River, Wisconsin

Provider Information

NPI Number: 1164121257
Entity Type: Organization
Organization Name: Aegis Group Practice LLC
Primary Specialty: Physical Therapist
Enumeration Date: Feb 27, 2023
Last Updated: Feb 27, 2023

Practice Location

Address: 101 HOMETOWN AVE
City: Fall River
State: Wisconsin
ZIP Code: 53932-9645
Phone: (800) 444-6845

Authorized Official

Name: MISTY S WILSON
Title: CONTRACT & CREDENTIALING SPECIALIST
Phone: (972) 372-6779

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Speech-Language Pathologist	235Z00000X
Physical Therapist	225100000X	Primary

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