Organization
AEGIS GROUP PRACTICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MCOLVIN (VICE PRESIDENT - FINANCE)
(479) 201-6000
Entity
Organization
Contact information
Practice address
81 PEACHTREE PARK DR NE, ATLANTA, GA 30309-1303
(800) 444-6845
(479) 478-2852
Mailing address
1000 FIANNA WAY # MD5740, FORT SMITH, AR 72919-9008
(479) 201-6089
(479) 935-2970
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
08/08/2017
Last updated
10/16/2017
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