NPI 1265203046 · live from the CMS NPI Registry
Aegis Group Practice LLC
Physical Therapist in Happy Valley, OR. National Provider Identifier 1265203046, active.
NPI record
| NPI | 1265203046 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Physical Therapist 225100000X |
| Practice location | 12154 Se 114th Ct, Happy Valley, OR 97086 |
| Practice phone | 479-201-6091 |
| Mailing address | 4933 Old Greenwood Rd, Fort Smith, AR 72903 |
| Enumerated | January 11, 2024 |
| Last updated | January 11, 2024 |
| Authorized official | Tracy Mccall, Credentialing |
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.