Organization
BELLA256 BOUTIQUE LLC
Active
Other names
Bella256 Boutique LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LISA S LYLES RN (PRESIDENT)
(256) 453-9070
Entity
Organization
Contact information
Practice address
1251 HAWTHORNE CIR, MADISON, GA 30650-5099
(256) 453-9070
Mailing address
1251 HAWTHORNE CIR, MADISON, GA 30650-5099
(256) 453-9070
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
06/12/2025
Last updated
06/12/2025
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