Organization
ALTA RIDGE FOOT SPECIALISTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT VAN BREDERODE DPM (OWNER/PROVIDER)
(828) 680-1161
Entity
Organization
Contact information
Practice address
105 CHESTNUT ST, MARS HILL, NC 28754-9602
(828) 680-1161
Mailing address
440 ALTAPASS HWY, SPRUCE PINE, NC 28777-3011
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
213ES0131X
Foot Surgery Podiatrist
—
—
Other
Enumeration date
04/22/2013
Last updated
01/10/2020
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