Individual
LISA LYLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
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
171W00000X
Contractor
Primary
—
—
1744P3200X
Prosthetics Case Management
—
—
Other
Enumeration date
12/31/2019
Last updated
06/20/2025
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