Individual
DR. GRANT DERRIL GWINNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
801 E 3RD ST, ELLSWORTH, KS 67439-4224
(785) 472-3272
(785) 472-3360
Mailing address
801 E 3RD ST, ELLSWORTH, KS 67439-4224
(785) 472-3272
(785) 472-3360
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
KS9613
KS
Other
Enumeration date
12/01/2005
Last updated
07/08/2007
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