| NPI | 1043263007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR STEPHEN SODERSTROM Physician Owner 920-261-9610 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2025-02-26 |