# AEGIS GROUP PRACTICE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** AEGIS GROUP PRACTICE LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1447773957
- **Legal business name:** AEGIS GROUP PRACTICE LLC
- **Authorized official:** MICHAEL MCOLVIN (VICE PRESIDENT OF FINANCE)
- **Authorized official phone:** (479) 201-6100

## Contact information

- **Practice address:** 11175 27TH AVE SE, BECKER, MN 55308-4774
- **Practice address phone:** (800) 444-6845
- **Practice address fax:** (479) 478-2852
- **Mailing address:** 1000 FIANNA WAY \# MD5740, FORT SMITH, AR 72919-9008
- **Mailing address phone:** (479) 201-6089
- **Mailing address fax:** (479) 935-2970

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 07/18/2017
- **Last updated:** 03/10/2026