Organization
AEG KENTUCKY PROFESSIONAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN CHUDNER (OWNER)
(314) 741-8183
Entity
Organization
Contact information
Practice address
111 E 4TH ST STE 440, ALTON, IL 62002-6206
(618) 462-9818
(314) 741-4947
Mailing address
111 E 4TH ST STE 440, ALTON, IL 62002-6206
(618) 462-9818
(314) 741-4947
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
01/29/2024
Last updated
06/20/2024
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