Organization
AEGIS GROUP PRACTICE LLC
Active
Parent organization
AEGIS THERAPIES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
AEGIS THERAPIES, INC.
Authorized official
MISTY S WILSON (CONTRACT/CREDENTIALING SPECIALIST)
(972) 372-6779
Entity
Organization
Contact information
Practice address
5050 KIMBALL BRIDGE RD, JOHNS CREEK, GA 30005-4511
(479) 201-2000
(479) 201-4801
Mailing address
2601 NETWORK BLVD STE 102, FRISCO, TX 75034-9092
(972) 372-6779
(479) 668-0872
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
07/05/2016
Last updated
09/15/2022
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