Aegis Group Practice LLC

NPI #1265205736 in Springfield, Illinois

Provider Information

NPI Number: 1265205736
Entity Type: Organization
Organization Name: Aegis Group Practice LLC
Primary Specialty: Physical Therapist
Enumeration Date: Nov 6, 2023
Last Updated: Nov 6, 2023

Practice Location

Address: 4012 COCKRELL LN
City: Springfield
State: Illinois
ZIP Code: 62711-8327
Phone: (479) 201-6091

Authorized Official

Name: TRACY MCCALL
Title: CREDENTIALING
Phone: (479) 201-6091

Specialties & Taxonomy Codes

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

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