Individual
BLAINE LANDON BURDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
211 4TH ST NE STE 1, DEVILS LAKE, ND 58301-2479
(701) 662-2817
(701) 662-2040
Mailing address
211 4TH ST NE STE 1, P O BOX 888, DEVILS LAKE, ND 58301-2479
(701) 662-2817
(701) 662-2040
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
675
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235393489
ND BLUE CROSS/SHIELD
ND
05
—
60678
—
ND
01
—
893212
ND VISION SERVICES
ND
Enumeration date
07/17/2008
Last updated
04/08/2010
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