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Grand Lake Podiatry, Inc.

Grand Lake Podiatry, Inc. is a health care provider in Celina, OH. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 148 N Main St, Bluffton, OH 45817-1246, US
Practice Location Phone419-358-3050
Practice Location Fax419-358-0240
Legal Business NameGRAND LAKE PODIATRY, INC.
NPI ?1548377500
Entity TypeOrganization
Enumeration Date ? Aug 24, 2006
Last Update Date ? Apr 18, 2008
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Grand Lake Podiatry, Inc.

SpecialtySpecializationLicenseLicense State
PodiatristFoot & Ankle Surgery

legacy-id-icon Legacy Provider IDs of Grand Lake Podiatry, Inc.

Provider IdIssuer StateIssuer TypeIssuer
2057929OhioMedicaid

official-icon Authorized Official of Grand Lake Podiatry, Inc.

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Grand Lake Podiatry, Inc.'s status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Dr. Mary Katherine Benjamin-swonger (DPM)
Authorized Official Title/PositionPODIATRIST/OWNER-PRESIDENT
Authorized Official Phone Number419-586-7874