Organization
INDIAN RIVER PODIATRY, PA
Active
Parent organization
INDIAN RIVER PODIATRY, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDIAN RIVER PODIATRY, PA
Authorized official
NICHOLAS WARD RUTLEDGE (OWNER)
(772) 569-0081
Entity
Organization
Contact information
Practice address
1515 US HIGHWAY 1 STE 204, SEBASTIAN, FL 32958-1612
(772) 569-0081
Mailing address
PO BOX 99, VERO BEACH, FL 32961-0099
(772) 569-0081
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
02/05/2020
Last updated
02/05/2020
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