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NPI 1598529778 · live from the CMS NPI Registry

Aegis Group Practice LLC

Physical Therapist in Lake Oswego, OR. National Provider Identifier 1598529778, active.

NPI record

NPI1598529778 Type 2 · organization
StatusActive
Primary specialtyPhysical Therapist 225100000X
Practice location1200 Overlook Dr, Lake Oswego, OR 97034
Practice phone479-201-6091
Mailing address4933 Old Greenwood Rd, Fort Smith, AR 72903
EnumeratedFebruary 8, 2024
Last updatedFebruary 8, 2024
Authorized officialTracy Mccall, Credentialing

Taxonomies and licenses

TaxonomyCodeLicense
Occupational Therapist225X00000X—
Speech-Language Pathologist, 235Z00000X—
Physical Therapist primary225100000X—

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.