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 D.P.M. (PRESIDENT)
(920) 261-9610
Entity
Organization
Contact information
Practice address
1461 W MAIN ST, WHITEWATER, WI 53190-1568
(920) 563-2136
(920) 563-3673
Mailing address
101 OAKRIDGE CT, SUITE A, WATERTOWN, WI 53094-4100
(920) 261-9610
(920) 261-9671
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43264800
—
WI
Enumeration date
02/14/2007
Last updated
11/01/2007
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