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Grand Lake Podiatry, Inc
Foot & Ankle Surgery Podiatrist in Minster, Ohio
NPI 1164694428

Grand Lake Podiatry, Inc is a Foot & Ankle Surgery Podiatrist based in Celina, OH and is specialized in Foot & Ankle Surgery. Grand Lake Podiatry, Inc practices in Minster, OH. The NPI Number for Grand Lake Podiatry, Inc is 1164694428 and holds a License No. 36 002772 (Ohio).

The current practice location address for Grand Lake Podiatry, Inc is 6 Eagle Dr, Minster, OH and can be reached out via phone at 419-628-7874 and via fax at 419-628-4620.

Location: 6 Eagle Dr, Minster, OH, 45822-8305
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1164694428
Provider Name
Grand Lake Podiatry, Inc
Credential
Provider Entity Type
Organization
Address
6 Eagle Dr, Minster, OH, 45822-8305
Phone Number
419-628-7874
Fax Number
419-628-4620
Provider Enumeration Date
03/27/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2544876 05 OH
institution
Provider Business Practice Location Address Details
Address
6 Eagle Dr
City
Minster
State
Ohio
Zip
45865-9714
Phone Number
419-628-7874
Fax Number
419-628-4620
person
Provider Business Mailing Address Details
Address
6 Eagle Dr
City
Minster
State
Ohio
Zip
45865-9714
Phone Number
419-628-7874
Fax Number
419-628-4620
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
213ES0103X
License No.
36 002772 (Ohio)
Definition
Definition to come...
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