Organization
JADE DRAGON RED PHOENIX, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN ANN MILAZZO ACA (CO-OWNER)
(318) 521-0701
Entity
Organization
Contact information
Practice address
2106 N 7TH ST, #132, WEST MONROE, LA 71291-4445
(318) 521-0701
Mailing address
158 DOWNS RD, RUSTON, LA 71270-6984
(318) 521-0701
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
ACA.200053
LA
Other
Enumeration date
10/27/2014
Last updated
10/27/2014
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