Healthcare Provider Details

I. General information

NPI: 1760683841
Provider Name (Legal Business Name): RED ROCKS FOOT & ANKLE CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 04/22/2020
Certification Date: 04/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 W DRY CREEK CIR #110
LITTLETON CO
80120-8078
US

IV. Provider business mailing address

11 W DRY CREEK CIR #110
LITTLETON CO
80120-8078
US

V. Phone/Fax

Practice location:
  • Phone: 303-797-6001
  • Fax: 303-797-7452
Mailing address:
  • Phone: 303-797-6001
  • Fax: 303-797-7452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number623
License Number StateCO

VIII. Authorized Official

Name: KATY HORAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 303-797-6001