Organization
C. THOMAS DEROCHE, DPM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER THOMAS DEROCHE DPM (OWNER/PROVIDER)
(715) 344-9500
Entity
Organization
Contact information
Practice address
2020 COUNTY RD HH, PLOVER, WI 54467
(715) 344-9500
(715) 344-9501
Mailing address
2020 COUNTY RD HH, PLOVER, WI 54467
(715) 344-9500
(715) 344-9501
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
703-025
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43220000
—
WI
Enumeration date
08/29/2007
Last updated
05/22/2019
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