B. MICHAEL SOUTHAM, OD, PC

RENO, NV
NPI1235550146
Doing Business AsBLACK ROCK VISION CENTER
Entity TypeOrganization
Authorized ContactBRANT MICHAEL SOUTHAM
Owner/President
775-825-0559
Organization Subpart ?No
Primary Taxonomy152W00000X Optometrist
(Licence: NV  779)
Enumeration Date2013-12-18
Last Update Date2013-12-18
Business Address
B. MICHAEL SOUTHAM, OD, PC
3201 LAKESIDE DR
RENO, NV 89509-4830
Phone number: 775-825-0559
Mailing Address
B. MICHAEL SOUTHAM, OD, PC
3201 LAKESIDE DR
RENO, NV 89509-4830
Phone number: 775-825-0559