OrganizationActive
Grand Lake Podiatry, Inc
NPI 1164694428 · Foot & Ankle Surgery Podiatrist · Minster, OH
Provider details
- NPI number
- 1164694428
- Entity type
- Organization
- Primary specialty
- Foot & Ankle Surgery PodiatristPodiatric Medicine & Surgery Service Providers
- Organization subpart
- No
- Authorized official
- Mary Benjamin-Swonger, Podiatrist/Owner-President(419) 586-7874
- License
- 36 002772 (OH)
Specialties & taxonomies
Podiatric Medicine & Surgery Service Providers
Practice location
6 Eagle Dr
Minster, OH 45865-9714
Phone: (419) 628-7874
Fax: (419) 628-4620
Approximate (ZIP-level) locationGet directions
Mailing address
1222 Irmscher Blvd
Celina, OH 45822-8305
Registry dates
- Enumerated
- 2008-03-27
- Last updated
- 2008-04-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.