# JADE DRAGON RED PHOENIX, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184029662
- **Authorized official:** MRS. KATHLEEN ANN MILAZZO ACA (CO-OWNER)
- **Authorized official phone:** (318) 521-0701

## Contact information

- **Practice address:** 2106 N 7TH ST, \#132, WEST MONROE, LA 71291-4445
- **Practice address phone:** (318) 521-0701
- **Mailing address:** 158 DOWNS RD, RUSTON, LA 71270-6984
- **Mailing address phone:** (318) 521-0701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | ACA.200053 | LA | Yes |

## Other

- **Enumeration date:** 10/27/2014
- **Last updated:** 10/27/2014