Organization
ROCK RIVER FOOT & ANKLE CLINIC, SC
Active
Parent organization
ROCK RIVER FOOT & ANKLE CLINIC, SC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROCK RIVER FOOT & ANKLE CLINIC, SC
Authorized official
DR. VICTOR STEPHEN SODERSTROM DPM (PHYSICIAN OWNER)
(920) 261-9610
Entity
Organization
Contact information
Practice address
101 OAKRIDGE CT, STE A, WATERTOWN, WI 53094-4150
(920) 261-9610
(920) 261-9671
Mailing address
PO BOX 825159, PHILADELPHIA, PA 19182-5159
(920) 261-9610
(920) 261-9671
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43264800
—
WI
Enumeration date
05/18/2006
Last updated
02/26/2025
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