GRAND LAKE FOOT & ANKLE INC NPI 1841576998

NPI Information

GRAND LAKE FOOT & ANKLE INC is a podiatrist in Celina, OH. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. GRAND LAKE FOOT & ANKLE INC NPI is 1841576998. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1222 IRMSCHER BLVD
CELINA, OH
ZIP 45822-305
Phone: (419) 586-7874
Fax: (419) 586-2776

The provider's authorized official is Mary Benjamin Swonger .
The authorized official title is Dpm and has the following contact phone number (419) 586-7874.

The CLIA number assigned to this NPI record is 36D0656247 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/2/2011 and was last updated on 3/22/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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