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
S64W13780 JANESVILLE RD, MUSKEGO, WI 53150-2743
(800) 444-6845
(479) 478-2852
Mailing address
4933 OLD GREENWOOD RD, FORT SMITH, AR 72903-6906
(479) 201-6147
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
01/22/2019
Last updated
03/10/2022
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