OrganizationActive
Aegis Group Practice LLC
NPI 1346949443 · Physical Therapist · Boise, ID
Provider details
- NPI number
- 1346949443
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Misty Wilson, Contract & Credentialing Specialist(972) 372-6779
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Speech-Language Pathologist235Z00000X
Speech, Language and Hearing Service Providers
- Occupational Therapist225X00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
4890 N Cloverdale Rd
Boise, ID 83713-2401
Phone: (800) 444-6845
Fax: (479) 478-2852
Approximate (ZIP-level) locationGet directions
Mailing address
2601 Network Blvd Ste 102
Frisco, TX 75034-9092
Registry dates
- Enumerated
- 2023-02-27
- Last updated
- 2023-02-27
- Certified
- 2023-02-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.