MEDICARE: AEGIS THERAPIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	9164	MN

General Provider Information

NPI Number	:	1609272160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AEGIS THERAPIES

Provider Business Mailing Address
First Line	:	7012 LAKE RD
Second Line	:
City	:	WOODBURY
State	:	MN
Zip	:	55125-2433
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7012 LAKE RD
Second Line	:
City	:	WOODBURY
State	:	MN
Zip	:	55125-2433
Country	:	US
Telephone Number	:	651-287-6527
Fax Number	:

Authorized Official
Title or Position	:	M.S CCC-SLP
Name	:	ELIZABETH OHMANN
Credential	:
Telephone Number	:	651-287-6527

Provider Enumeration Date	:	11/11/2014
Last Update Date	:	11/11/2014

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Directions to “AEGIS THERAPIES ” Practice Location

Language	Start Address	Practice Location

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