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Grand Lake Podiatry Inc
Foot & Ankle Surgery Podiatrist in Springfield, Ohio
NPI 1184896177

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 Springfield, OH. The NPI Number for Grand Lake Podiatry Inc is 1184896177 and holds a License No. 36 002772 (Ohio).

The current practice location address for Grand Lake Podiatry Inc is 2624 Lexington Ave, Springfield, OH and can be reached out via phone at 937-322-3346 and via fax at 937-322-3348.

Location: 2624 Lexington Ave, Springfield, OH, 45822-8305
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1184896177
Provider Name
Grand Lake Podiatry Inc
Credential
Provider Entity Type
Organization
Address
2624 Lexington Ave, Springfield, OH, 45822-8305
Phone Number
937-322-3346
Fax Number
937-322-3348
Provider Enumeration Date
03/31/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2544885 05 OH
institution
Provider Business Practice Location Address Details
Address
2624 Lexington Ave
City
Springfield
State
Ohio
Zip
45505-2607
Phone Number
937-322-3346
Fax Number
937-322-3348
person
Provider Business Mailing Address Details
Address
2624 Lexington Ave
City
Springfield
State
Ohio
Zip
45505-2607
Phone Number
937-322-3346
Fax Number
937-322-3348
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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