Aeg Wisconsin Professional Ltd

NPI #1407801087 in Hudson, Wisconsin

Provider Information

NPI Number: 1407801087
Entity Type: Organization
Organization Name: Aeg Wisconsin Professional Ltd
Primary Specialty: Optometrist
Enumeration Date: May 23, 2006
Last Updated: Sep 2, 2025

Practice Location

Address: 2215 VINE ST
Address 2: SUITE E
City: Hudson
State: Wisconsin
ZIP Code: 54016-5802
Phone: (715) 381-1234

Authorized Official

Name: CASEY BENNINGTON
Title: AUTHORIZED OFFICIAL
Phone: (618) 462-9818

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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