Organization · Type 2 NPI
Grand Lake Podiatry, Inc
Foot & Ankle Surgery Podiatrist · Minster, OH
NPI number
1164694428
Active
Practice location
6 Eagle Dr
Minster, OH 45865-9714
Fax (419) 628-4620
Mailing address
1222 Irmscher Blvd
Celina, OH 45822-8305
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | 36 002772 (OH) |
Foot & Ankle Surgery Podiatrist: Definition to come...
About NPI 1164694428
Grand Lake Podiatry, Inc's National Provider Identifier is 1164694428, issued on Mar 27, 2008. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Minster, OH. The record was last updated on Apr 18, 2008.