| NPI | 1912562596 |
|---|---|
| Doing Business As | BLACK ROCK VISION CENTER |
| Entity Type | Organization |
| Authorized Contact | KATHRYN SOUTHAM Manager 775-825-0559 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-05-08 |