Organization
WHARTON ENTERPRISES LTD
Active
Parent organization
WHARTON ENTERPRISES LTD
Other names
Neurosoma of Illinois
Organization subpart
Yes
Provider details
NPI number
Legal business name
WHARTON ENTERPRISES LTD
Authorized official
MRS. LISA F WHARTON LMT (OWNER/SHAREHOLDER)
(618) 889-3220
Entity
Organization
Contact information
Practice address
106 S VICKSBURG ST, MARION, IL 62959-1930
(618) 992-2322
(618) 992-2345
Mailing address
PO BOX 1191, MARION, IL 62959-7691
(618) 889-3220
(618) 992-2345
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053709519
—
IL
05
—
1548043946
—
IL
05
—
1790564383
—
IL
Enumeration date
11/06/2023
Last updated
11/06/2023
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