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General NPI Number Information
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NPI Number | 1154449155
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Entity Type | Organization
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Legal Business Name | REDROCK CHIROPRACTIC INC
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 500 S RANCHO DR STE A1
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City | LAS VEGAS
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State | NV
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Zip | 89106-4844
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Country | US
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Telephone | 702-880-5335
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Fax | 702-880-5336
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Provider Business Mailing Address
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Address Line | 500 S RANCHO DR STE A1
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City | LAS VEGAS
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State | NV
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Zip | 89106-4844
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Country | US
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Telephone | 702-880-5335
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Fax | 702-880-5336
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARGARET R COLUCCI
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Credential | DC
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Telephone | 702-880-5335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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