Aeg Kentucky Professional, Pllc

NPI #1467214080 in Alton, Illinois

Provider Information

NPI Number: 1467214080
Entity Type: Organization
Organization Name: Aeg Kentucky Professional, Pllc
Primary Specialty: Optometrist
Enumeration Date: Jan 29, 2024
Last Updated: Jun 20, 2024

Practice Location

Address: 111 E 4TH ST STE 440
City: Alton
State: Illinois
ZIP Code: 62002-6206
Phone: (618) 462-9818

Authorized Official

Name: BENJAMIN CHUDNER
Title: OWNER
Phone: (314) 741-8183

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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