Organization
BELLA MONIQUE LLC
Active
Other names
Elite Medical Wigs LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SHAVONNE BELLAMY (CEO)
(912) 722-3281
Entity
Organization
Contact information
Practice address
1445 WOODMONT LN NW # 1205, ATLANTA, GA 30318-2866
(912) 288-5907
(912) 452-1130
Mailing address
PO BOX 1174, BLACKSHEAR, GA 31516-3674
(912) 288-5907
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
12/15/2021
Last updated
02/20/2023
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