Organization
AEGIS GROUP PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY MCCALL (CREDENTIALING)
(479) 201-6091
Entity
Organization
Contact information
Practice address
351 MASON ST NW, ONALASKA, WI 54650-7037
(479) 201-6091
Mailing address
4933 OLD GREENWOOD RD, FORT SMITH, AR 72903-6906
(479) 201-6091
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
05/12/2025
Last updated
05/12/2025
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