Individual
EMILY MARY GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
501 S LOCUST ST, MANTENO, IL 60950-1654
(815) 468-2015
(815) 468-2013
Mailing address
501 S LOCUST ST, MANTENO, IL 60950-1654
(815) 468-2015
(815) 468-2013
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.010407
IL
Other
Enumeration date
08/24/2010
Last updated
02/04/2016
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