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Contact Information

AEGIS GROUP PRACTICE LLC
4400 LANGE AVE NE
SAINT MICHAEL, MN55376-9556
 Phone: 763-777-9445
 Fax: 479-401-2173
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for AEGIS GROUP PRACTICE LLC

NPI Number 1881311421
LBN Legal business name AEGIS GROUP PRACTICE LLC
Authorized official MISTY WILSON - (CONTRACT/CREDENTIALING REP)
Entity Organization
Organization subpart 1 No
Enumeration date 10/25/2022
Last updated 10/25/2022 - About 4 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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