# ROCK RIVER FOOT AND ANKLE CLINIC SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245025071
- **Authorized official:** ROSALIE KREIGHBAUM (REGIONAL CREDENTIALING SPECIALIST)
- **Authorized official phone:** (314) 909-1920

## Contact information

- **Practice address:** 422 SUMMIT AVE, OCONOMOWOC, WI 53066-3749
- **Practice address phone:** (262) 490-4568
- **Mailing address:** PO BOX 825159, PHILADELPHIA, PA 19182-5159
- **Mailing address phone:** (866) 626-1540

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 04/11/2025
- **Last updated:** 04/11/2025