NPI 1235845504 · live from the CMS NPI Registry
Aegis Group Practice LLC
Physical Therapist in Goodyear, AZ. National Provider Identifier 1235845504, active.
NPI record
| NPI | 1235845504 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Physical Therapist 225100000X |
| Practice location | 14930 W Wigwam Blvd, Goodyear, AZ 85395 |
| Practice phone | 800-444-6845 |
| Mailing address | 2601 Network Blvd Ste 102, Frisco, TX 75034 |
| Enumerated | January 30, 2023 |
| Last updated | January 30, 2023 |
| Authorized official | Misty Wilson, Contract & Credentialing Specialist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Occupational Therapist | 225X00000X | — |
| Speech-Language Pathologist, | 235Z00000X | — |
| Physical Therapist primary | 225100000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.