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Grand Lake Podiatry Inc
Foot & Ankle Surgery Podiatrist in Celina, Ohio
NPI 1871765362

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 Celina, OH. The NPI Number for Grand Lake Podiatry Inc is 1871765362 and holds a License No. 36 002772 (Ohio).

The current practice location address for Grand Lake Podiatry Inc is 1222 Irmscher Blvd, Celina, OH and can be reached out via phone at 419-586-7874 and via fax at 419-586-2776.

Location: 1222 Irmscher Blvd, Celina, OH, 45822-8305
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1871765362
Provider Name
Grand Lake Podiatry Inc
Credential
Provider Entity Type
Organization
Address
1222 Irmscher Blvd, Celina, OH, 45822-8305
Phone Number
419-586-7874
Fax Number
419-586-2776
Provider Enumeration Date
03/25/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2056313 05 OH
institution
Provider Business Practice Location Address Details
Address
1222 Irmscher Blvd
City
Celina
State
Ohio
Zip
45822-8305
Phone Number
419-586-7874
Fax Number
419-586-2776
person
Provider Business Mailing Address Details
Address
1222 Irmscher Blvd
City
Celina
State
Ohio
Zip
45822-8305
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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