Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dessalines Sports Medicine, LLC

Organization Clinic/Center · NPI 1407321581

Dessalines Sports Medicine, LLC is a Clinic/Center in Mesa, Arizona. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6424 E Broadway Rd Ste 102
Mesa, AZ 85206-1750
Phone: (480) 634-4606
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X

Record details

NPI number1407321581
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charles Peterson — Doctor · (480) 634-4606
NPI enumeratedOctober 4, 2018
Last updated in NPPESOctober 4, 2018
Mailing address6424 E Broadway Rd Ste 102, Mesa, AZ 85206-1750

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