Provider Demographics
NPI:1689276610
Name:RED ROCK NATURAL MEDICINE LLC
Entity Type:Organization
Organization Name:RED ROCK NATURAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:YOOJIN
Authorized Official - Middle Name:MEDICINE
Authorized Official - Last Name:LEE-SEDERA
Authorized Official - Suffix:
Authorized Official - Credentials:OMD ND
Authorized Official - Phone:702-708-2207
Mailing Address - Street 1:3030 S JONES BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-6793
Mailing Address - Country:US
Mailing Address - Phone:702-708-2207
Mailing Address - Fax:
Practice Address - Street 1:3030 S JONES BLVD STE 107
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6793
Practice Address - Country:US
Practice Address - Phone:702-708-2207
Practice Address - Fax:888-809-4639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty