Organization · Type 2 NPI
Grand Lake Podiatry Inc
Foot & Ankle Surgery Podiatrist · Van Wert, OH
NPI number
1992977987
Active
Practice location
140 Fox Rd, STE104
Van Wert, OH 45891-2475
Fax (419) 586-2776
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...
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Other foot & ankle surgery podiatrist providers in Van Wert
About NPI 1992977987
Grand Lake Podiatry Inc's National Provider Identifier is 1992977987, issued on Mar 31, 2008. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Van Wert, OH. The record was last updated on Feb 1, 2011.