Organization
DANCING PHOENIX PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH P WILDE AP (ACUPUNCTURIST/OWNER)
(904) 651-0940
Entity
Organization
Contact information
Practice address
2850 ISABELLA BLVD STE 50, JACKSONVILLE BEACH, FL 32250-8004
(904) 651-0940
Mailing address
3373 PINTAIL DR N, JACKSONVILLE BEACH, FL 32250-3041
(904) 651-0940
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP3056
FL
Other
Enumeration date
04/09/2013
Last updated
04/09/2013
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