Aegis Group Practice LLC

NPI #1205557360 in Verona, Wisconsin

Provider Information

NPI Number: 1205557360
Entity Type: Organization
Organization Name: Aegis Group Practice LLC
Primary Specialty: Physical Therapist
Enumeration Date: Sep 7, 2022
Last Updated: Sep 7, 2022

Practice Location

Address: 841 N MAIN ST
City: Verona
State: Wisconsin
ZIP Code: 53593-1905
Phone: (800) 444-6845

Authorized Official

Name: MISTY S WILSON
Title: CONTRACT/CREDENTIALING REP
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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