Grand Lake Podiatry, INC

NPI #1164694428 in Minster, Ohio

Provider Information

NPI Number
1164694428
Entity Type
Organization
Organization Name
Grand Lake Podiatry, INC
Primary Specialty
Podiatrist - Foot & Ankle Surgery
Enumeration Date
Mar 27, 2008
Last Updated
Apr 18, 2008

Practice Location

Address
6 EAGLE DR
State
Ohio
ZIP Code
45865-9714
Phone
(419) 628-7874

Authorized Official

Name
DR. MARY KATHERINE BENJAMIN-SWONGER, DPM
Title
PODIATRIST/OWNER-PRESIDENT
Phone
(419) 586-7874

Specialties & Taxonomy Codes

Specialty
Podiatrist - Foot & Ankle SurgeryFoot & Ankle Surgery

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