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Individual

STAN SHOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
200 SHERWOOD GREEN CT, MASON, OH 45040-2257
(513) 238-1901
Mailing address
200 SHERWOOD GREEN CT, MASON, OH 45040-2257

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401199400211
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0088244
OH
Enumeration date
10/05/2014
Last updated
10/05/2014
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