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Individual
DR. LAURENCE FENN BOURLAND JR.
Active
Individual
DR. LAURENCE FENN BOURLAND JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
27 1194
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17032
STATE WORKER COMPENSATION
OR
Enumeration date
03/14/2007
Last updated
09/24/2010
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