Organization
AEG SOUTH CAROLINA PROFESSIONAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA K ALLISON (SR. DIR. RCM/MVC)
(618) 462-9818
Entity
Organization
Contact information
Practice address
121 LUCY LN, COLUMBIA, SC 29229-7835
(803) 217-2550
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
07/19/2023
Last updated
05/08/2025
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