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Grand Lake Podiatry, Inc
Foot & Ankle Surgery Podiatrist in Wapakoneta, Ohio
NPI 1538331525

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 Wapakoneta, OH. The NPI Number for Grand Lake Podiatry, Inc is 1538331525 and holds a License No. 36 002772 (Ohio).

The current practice location address for Grand Lake Podiatry, Inc is 812 Redskin Trl, Wapakoneta, OH and can be reached out via phone at 419-586-7874 and via fax at 419-586-2776.

Location: 812 Redskin Trl, Wapakoneta, OH, 45822-8305
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1538331525
Provider Name
Grand Lake Podiatry, Inc
Credential
Provider Entity Type
Organization
Address
812 Redskin Trl, Wapakoneta, OH, 45822-8305
Phone Number
419-586-7874
Fax Number
419-586-2776
Provider Enumeration Date
03/31/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2544901 05 OH
institution
Provider Business Practice Location Address Details
Address
812 Redskin Trl
City
Wapakoneta
State
Ohio
Zip
45895-8545
Phone Number
419-586-7874
Fax Number
419-586-2776
person
Provider Business Mailing Address Details
Address
812 Redskin Trl
City
Wapakoneta
State
Ohio
Zip
45895-8545
Phone Number
419-586-7874
Fax Number
419-586-2776
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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