# AEG WISCONSIN VISION THERAPY LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407589740
- **Authorized official:** MELISSA ALLISON (SENIOR DIRECTOR RCM/MVC)
- **Authorized official phone:** (618) 462-9818

## Contact information

- **Practice address:** 2215 VINE ST STE C, HUDSON, WI 54016-5862
- **Practice address phone:** (715) 381-1577
- **Practice address fax:** (715) 381-5357
- **Mailing address:** 111 E 4TH ST STE 440, ALTON, IL 62002-6241
- **Mailing address phone:** (618) 462-9818

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152WV0400X | Vision Therapy Optometrist | — | NULL | Yes |
| 152WV0400X | Vision Therapy Optometrist | — | — | Yes |

## Other

- **Enumeration date:** 07/05/2022
- **Last updated:** 07/05/2022