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Organization

FOOT & ANKLE INSTITUTE OF SPORTS MEDICINE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RACHELLE RANDALL DPM (COO)
(810) 650-7113
Entity
Organization

Contact information

Practice address
1107 STONE ST STE 3, PORT HURON, MI 48060-3569
(810) 204-4494
(810) 479-9640
Mailing address
1107 STONE ST STE 3, PORT HURON, MI 48060-3569
(810) 204-4494
(810) 479-9640

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary

Other

Enumeration date
04/17/2023
Last updated
02/11/2025
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