Grand Lake Podiatry INC

NPI #1992977987 in Van Wert, Ohio

Provider Information

NPI Number: 1992977987
Entity Type: Organization
Organization Name: Grand Lake Podiatry INC
Primary Specialty: Podiatrist - Foot & Ankle Surgery
Enumeration Date: Mar 31, 2008
Last Updated: Feb 1, 2011

Practice Location

Address: 140 FOX RD
Address 2: STE104
City: Van Wert
State: Ohio
ZIP Code: 45891-2475
Phone: (419) 586-7874

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist - Foot & Ankle Surgery — Foot & Ankle Surgery	213ES0103X	Primary

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Individual Providers

Provider Name	Specialty	City
DR. Charles Joseph Hoehn, D.P.M	Podiatrist - Foot & Ankle Surgery	Van Wert	AI Deep Dive
William G Tabbert, D.P.M.	Podiatrist - Foot & Ankle Surgery	Marion	AI Deep Dive
DR. Scot F. Bertolo, DPM	Podiatrist - Foot & Ankle Surgery	Columbus	AI Deep Dive
DR. Nicholas A. Campitelli, D.P.M.	Podiatrist - Foot & Ankle Surgery	Fairlawn	AI Deep Dive

Organizations

Provider Name	Specialty	City
Van Wert Medical Services, Ltd. Part of Van Wert Medical Services, Ltd.	Podiatrist - Foot & Ankle Surgery	Van Wert	AI Deep Dive

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