Organization
WILD EDEN WIG BOUTIQUE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANICA CASSINELLI (OWNER)
(859) 991-4566
Entity
Organization
Contact information
Practice address
5100 WEDGEWAY DR, LOVELAND, OH 45140-6568
(859) 991-4566
Mailing address
5100 WEDGEWAY DR, LOVELAND, OH 45140-6568
(859) 991-4566
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
10/17/2025
Last updated
10/17/2025
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