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.
|Practice Location|| 148 N Main St, Bluffton, OH 45817-1246, US |
|Practice Location Phone||419-358-3050|
|Practice Location Fax||419-358-0240|
|Legal Business Name||GRAND LAKE PODIATRY, INC.|
|Enumeration Date ? ||Aug 24, 2006|
|Last Update Date ? ||Apr 18, 2008|
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).
Specialties & Licenses of Grand Lake Podiatry, Inc.
|Specialty||Provider Type||Specialization||License||License State|
|Podiatrist||Podiatric Medicine & Surgery Service Providers||Foot & Ankle Surgery |
Legacy Provider IDs of Grand Lake Podiatry, Inc.
|Provider Id||Issuer State||Issuer Type||Issuer|
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/Position||PODIATRIST/OWNER-PRESIDENT|
|Authorized Official Phone Number||419-586-7874|