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Organization
CHIPPEWA VALLEY FOOT AND ANKLE CLINIC SC
Active
Organization
CHIPPEWA VALLEY FOOT AND ANKLE CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC F CAPORUSSO DPM (PRESIDENT)
(715) 832-1400
Entity
Organization
Contact information
Practice address
4212 SOUTHTOWN DR, EAU CLAIRE, WI 54701-2635
(715) 832-1400
(715) 832-4187
Mailing address
4212 SOUTHTOWN DR, EAU CLAIRE, WI 54701-2635
(715) 832-1400
(715) 832-4187
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
848-025
WI
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43266700
—
WI
01
—
DB9751
MEDICARE RAILROAD
WI
Enumeration date
12/11/2006
Last updated
06/03/2008
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