Aegis Group Practice LLC
NPI #1366900136 in Port Washington, Wisconsin
Provider Information
- NPI Number
- 1366900136
- Entity Type
- Organization
- Organization Name
- Aegis Group Practice LLC
- Primary Specialty
- Physical Therapist
- Enumeration Date
- Mar 11, 2019
- Last Updated
- Sep 15, 2022
Practice Location
- Address
- 1330 W LINCOLN AVE
- City
- Port Washington
- State
- Wisconsin
- ZIP Code
- 53074-2050
- Phone
- (800) 444-6845
Authorized Official
- Name
- MISTY S WILSON
- Title
- CONTRACT/CREDENTIALING SPECIALIST
- Phone
- (972) 372-6779
Specialties & Taxonomy Codes
| Specialty |
|---|
| Occupational Therapist |
| Speech-Language Pathologist |
| Physical Therapist |
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