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

Random Lake Spine & Sports Clinic

Organization Clinic/Center · NPI 1659543205

Random Lake Spine & Sports Clinic is a Clinic/Center in Random Lake, Wisconsin. Registered with an NPI since 2008.

In the registry since
2008

Practice location Address checks out

321 Carroll St
Random Lake, WI 53075
Phone: (920) 994-2000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X

Record details

NPI number1659543205
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jason Rudelich — President · (920) 994-2000
NPI enumeratedMarch 24, 2008
Last updated in NPPESJune 2, 2008
Mailing addressPo Box 196, Random Lake, WI 53075-0196

Other providers in Random Lake