Organization
AEG OHIO PROFESSIONAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA ALLISON (SR. DIRECTOR MVC)
(314) 741-8183
Entity
Organization
Contact information
Practice address
28699 CHAGRIN BLVD STE 400, WOODMERE, OH 44122-4554
(216) 514-3002
Mailing address
211 E BROADWAY # 211, ALTON, IL 62002-6220
(618) 462-9818
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
10/20/2020
Last updated
02/19/2025
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