Provider Demographics
NPI:1508087024
Name:AEGIS HEALTH PARTNERS, P.C.
Entity Type:Organization
Organization Name:AEGIS HEALTH PARTNERS, P.C.
Other - Org Name:AEGIS CHIROPRACTIC & PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:413-586-5552
Mailing Address - Street 1:241 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-9558
Mailing Address - Country:US
Mailing Address - Phone:413-586-5552
Mailing Address - Fax:413-586-3330
Practice Address - Street 1:241 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-9558
Practice Address - Country:US
Practice Address - Phone:413-586-5552
Practice Address - Fax:413-586-3330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2745111N00000X
MA15956225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty