Organization
AEGIS GROUP PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY MCCALL (CONTRACT SPECIALIST)
(479) 201-6091
Entity
Organization
Contact information
Practice address
6490 CENTRAL AVE NE, FRIDLEY, MN 55432-5106
(800) 444-6845
Mailing address
4933 OLD GREENWOOD RD, FORT SMITH, AR 72903-6906
(479) 201-6091
(479) 935-2918
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
07/20/2023
Last updated
07/20/2023
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