Organization
WILLIAM BRUCE BOURLAND OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BOURLAND (PRESIDENT)
(307) 789-8820
Entity
Organization
Contact information
Practice address
701 FRONT ST, EVANSTON, WY 82930-3522
(307) 789-8820
Mailing address
701 FRONT ST, EVANSTON, WY 82930-3522
(307) 789-8820
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
203T
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102083800
—
WY
Enumeration date
03/04/2008
Last updated
01/24/2011
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