# PHOENIX RISES ACUPUNCTURE

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

## Provider details

- **NPI number:** 1326494006
- **Authorized official:** GORDANA SMITH LAC (OWNER)
- **Authorized official phone:** (904) 238-1000

## Contact information

- **Practice address:** 150 KENT RD, SUITE 2A, ST AUGUSTINE, FL 32086-6350
- **Practice address phone:** (904) 238-1000
- **Mailing address:** 150 KENT RD, SUITE 2A, ST AUGUSTINE, FL 32086-6350

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | AP 3712 | FL | Yes |

## Other

- **Enumeration date:** 05/11/2016
- **Last updated:** 05/11/2016