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Individual
MISS ILEANA BOURLAND
Active
Individual
MISS ILEANA BOURLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSOM LICAC
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AC00534
TX
171100000X
Acupuncturist
Primary
AC153140
OR
Other
Enumeration date
09/08/2006
Last updated
03/02/2011
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