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Organization
AEGIS GROUP PRACTICE LLC
Active
Organization
AEGIS GROUP PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY MCCALL (CREDENTIALING)
(479) 201-6091
Entity
Organization
Contact information
Practice address
1001 S PINE ST, BURLINGTON, WI 53105-2327
(262) 461-6571
(479) 935-9929
Mailing address
4933 OLD GREENWOOD RD, FORT SMITH, AR 72903-6906
(479) 201-6091
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
04/03/2025
Last updated
05/28/2025
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