Organization
AEGIS GROUP PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MCOLVIN (VP-FINANCE)
(479) 201-2000
Entity
Organization
Contact information
Practice address
3706 DAMON ST, EAU CLAIRE, WI 54701-9265
(800) 444-6845
Mailing address
1000 FIANNA WAY, FORT SMITH, AR 72919-9008
(479) 201-6089
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/11/2019
Last updated
03/11/2019
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