Individual
SALLY GRACE IRWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3012 ANDERSON AVE, MANHATTAN, KS 66503-2809
(785) 537-1118
(785) 537-8005
Mailing address
2800 SW WANAMAKER RD, SUITE 192, TOPEKA, KS 66614-4293
(785) 272-0707
(785) 272-0575
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1809
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200576690A
—
KS
Enumeration date
06/24/2008
Last updated
02/13/2012
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