Grand Lake Podiatry INC
NPI #1184896177 in Springfield, Ohio
Provider Information
- NPI Number
- 1184896177
- Entity Type
- Organization
- Organization Name
- Grand Lake Podiatry INC
- Primary Specialty
- Podiatrist - Foot & Ankle Surgery
- Enumeration Date
- Mar 31, 2008
- Last Updated
- Jun 9, 2011
Practice Location
- Address
- 2624 LEXINGTON AVE
- City
- Springfield
- State
- Ohio
- ZIP Code
- 45505-2607
- Phone
- (937) 322-3346
Authorized Official
- Name
- DR. MARY KATHERINE BENJAMIN-SWONGER, DPM
- Title
- PODIATRIST/OWNER-PRESIDENT
- Phone
- (419) 586-7874
Specialties & Taxonomy Codes
| Specialty |
|---|
| Podiatrist - Foot & Ankle Surgery — Foot & Ankle Surgery |
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