Organization
AEG DELAWARE PROFESSIONAL PA
Active
Parent organization
AEG DELAWARE PROFESSIONAL PA
Other names
Location 1 DE
Organization subpart
Yes
Provider details
NPI number
Legal business name
AEG DELAWARE PROFESSIONAL PA
Authorized official
MELISSA K ALLISON (SR. DIRECTOR RCM/MVC)
(618) 462-9818
Entity
Organization
Contact information
Practice address
111 E 4TH ST STE 440, ALTON, IL 62002-6206
(618) 462-9818
Mailing address
111 E 4TH ST STE 440, ALTON, IL 62002-6206
(618) 462-9818
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
08/08/2023
Last updated
08/17/2023
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