GRAND LAKE PODIATRY INC is a foot and ankle surgery podiatrist in Bellefontaine, OH. GRAND LAKE PODIATRY INC NPI is 1184896383. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
3772 US RT 68 S
BELLEFONTAINE, OH
ZIP 43311-311
Phone: (937) 599-3668
Fax: (937) 599-4852
The provider's authorized official is Mary Katherine Benjamin-swonger .
The authorized official title is Podiatrist/owner-president and has the following contact phone number (419) 586-7874.
The CLIA number assigned to this NPI record is 36D2140048 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 3/27/2008 and was last updated on 6/9/2011.