B Michael Southam O D PC
NPI #1235412784 in Brewster, Washington
Provider Information
- NPI Number
- 1235412784
- Entity Type
- Organization
- Organization Name
- B Michael Southam O D PC
- Primary Specialty
- Optometrist
- Enumeration Date
- Sep 21, 2011
- Last Updated
- Aug 6, 2012
Practice Location
- Address
- 123 HOSPITAL WAY
- City
- Brewster
- State
- Washington
- ZIP Code
- 98812-0578
- Phone
- (509) 689-2342
Authorized Official
- Name
- DR. BRANT MICHAEL SOUTHAM, O.D.
- Title
- OPTOMETRIST/OWNER
- Phone
- (509) 689-2342
Specialties & Taxonomy Codes
| Specialty |
|---|
| Optometrist |
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