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General NPI Number Information
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NPI Number | 1629631965
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Entity Type | Individual
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Provider Name | RACHELLE LYNN LEVEILLE DPM
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Gender | Female
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Dates
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Enumeration Date | 04/22/2019
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 126 S 25TH ST STE A
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City | ESCANABA
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State | MI
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Zip | 49829-1364
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Country | US
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Telephone | 906-786-2385
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Fax |
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Provider Business Mailing Address
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Address Line | 126 S 25TH ST STE A
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City | ESCANABA
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State | MI
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Zip | 49829-1364
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Country | US
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Telephone | 906-786-2385
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 5951001233
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License Number State | MI
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