# DANCING PHOENIX PLLC

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

## Provider details

- **NPI number:** 1942643978
- **Authorized official:** SARAH P WILDE AP (ACUPUNCTURIST/OWNER)
- **Authorized official phone:** (904) 651-0940

## Contact information

- **Practice address:** 2850 ISABELLA BLVD STE 50, JACKSONVILLE BEACH, FL 32250-8004
- **Practice address phone:** (904) 651-0940
- **Mailing address:** 3373 PINTAIL DR N, JACKSONVILLE BEACH, FL 32250-3041
- **Mailing address phone:** (904) 651-0940

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | AP3056 | FL | Yes |

## Other

- **Enumeration date:** 04/09/2013
- **Last updated:** 04/09/2013