| NPI | 1376385344 |
|---|---|
| Former Legal Business Name | EMOPTI PN PROFESSIONAL CORPORATION |
| Entity Type | Organization |
| Authorized Contact | JENNIFER WHALEN Director 217-737-3508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2024-11-22 |