Organization
HOUSE OF SHEARS SUITES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALLORY MARIE WASTSON (OWNER)
(513) 478-4169
Entity
Organization
Contact information
Practice address
5914 GLENWAY AVE, CINCINNATI, OH 45238-2009
(513) 462-9864
Mailing address
5914 GLENWAY AVE, CINCINNATI, OH 45238-2009
(513) 462-9864
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
01/12/2021
Last updated
01/15/2021
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