Grand Lake Podiatry, Inc.

NPI #1548377500 in Bluffton, Ohio

Provider Information

NPI Number
1548377500
Entity Type
Organization
Organization Name
Grand Lake Podiatry, Inc.
Primary Specialty
Podiatrist - Foot & Ankle Surgery
Enumeration Date
Aug 24, 2006
Last Updated
Apr 18, 2008

Practice Location

Address
148 N MAIN ST
State
Ohio
ZIP Code
45817-1246
Phone
(419) 358-3050

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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