Organization
AEG MICHIGAN PROFESSIONAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN CHUDNER (OWNER)
(618) 462-9818
Entity
Organization
Contact information
Practice address
1555 BRADY ST, CHESANING, MI 48616-1022
(989) 845-7050
(314) 741-4947
Mailing address
111 E 4TH ST STE 440, ALTON, IL 62002-6241
(618) 462-9818
(314) 741-4947
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
09/08/2022
Last updated
09/18/2023
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