Grant Derril Gwinner O.D.

NPI 1063496362 - Optometrist - 152W00000X

NPI Details
NPI 1063496362
Gender Male
Enumeration Date 12/01/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
801 E 3RD ST
ELLSWORTH KS, 67439-4224, US
Phone (785) 472-3272
Fax (785) 472-3360
Business Location
801 E 3RD ST
ELLSWORTH KS, 67439-4224, US
Phone (785) 472-3272
Fax (785) 472-3360
Toxanomy
Taxonomy Code 152W00000X
License State Kansas
License Number KS9613
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According to our database, Dr. Grant Derril Gwinner O.D. NPI is 1063496362, taxonomy code is 152W00000X and license number is KS9613, license state is located at Kansas. Grant Derril Gwinner O.D. physically located at 801 E 3rd St, Ellsworth KS, 67439-4224. NPI Number Grant Derril Gwinner O.D. has the Individual type.

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1063496362 NPI number is provided on an as is basis without warranty of any kind. 1063496362 is maintained by the National Plan & Provider Enumeration System. The contents of Grant Derril Gwinner O.D. are for informational purposes only.