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General NPI Number Information
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NPI Number | 1982994778
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Entity Type | Organization
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Legal Business Name | RED ROCK PODIATRY INC
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Dates
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Enumeration Date | 04/13/2011
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Last Update Date | 03/27/2020
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Provider Practice Location Address
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Address Line | 653 N TOWN CENTER DR STE 80
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City | LAS VEGAS
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State | NV
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Zip | 89144-0503
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Country | US
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Telephone | 702-233-7979
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Fax |
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Provider Business Mailing Address
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Address Line | 4132 S RAINBOW BLVD STE 138
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City | LAS VEGAS
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State | NV
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Zip | 89103-3106
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Country | US
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Telephone | 702-233-7979
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KRISTI KAMINSKY
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Credential | DPM
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Telephone | 702-233-7979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0902
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License Number State | NV
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