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Organization
PHOENIX RISES ACUPUNCTURE
Active
Organization
PHOENIX RISES ACUPUNCTURE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GORDANA SMITH LAC (OWNER)
(904) 238-1000
Entity
Organization
Contact information
Practice address
150 KENT RD, SUITE 2A, ST AUGUSTINE, FL 32086-6350
(904) 238-1000
Mailing address
150 KENT RD, SUITE 2A, ST AUGUSTINE, FL 32086-6350
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP 3712
FL
Other
Enumeration date
05/11/2016
Last updated
05/11/2016
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