MEDICARE: RED ROCK PODIATRY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	0902	NV

General Provider Information

NPI Number	:	1982994778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RED ROCK PODIATRY INC

Provider Business Mailing Address
First Line	:	4132 S RAINBOW BLVD STE 138
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-3106
Country	:	US
Telephone Number	:	702-233-7979
Fax Number	:

Provider Business Practice Location Address
First Line	:	653 N TOWN CENTER DR STE 80
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-0503
Country	:	US
Telephone Number	:	702-233-7979
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KRISTI KAMINSKY
Credential	:	DPM
Telephone Number	:	702-233-7979

Provider Enumeration Date	:	04/13/2011
Last Update Date	:	03/27/2020

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Directions to “RED ROCK PODIATRY INC ” Practice Location

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