Organization
EAGAN EYE CLINIC LLC
Active
Parent organization
EAGAN EYE CLINIC LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAGAN EYE CLINIC LLC
Authorized official
BENJAMIN S. CHUDNER OD (PRESIDENT)
(972) 370-5552
Entity
Organization
Contact information
Practice address
206 DIVISION ST, WAITE PARK, MN 56387-1331
(320) 235-0365
Mailing address
211 E BROADWAY, ALTON, IL 62002-6220
(618) 462-9818
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
10/02/2020
Last updated
10/02/2020
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