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Individual

MISS ILEANA BOURLAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSOM LICAC

Contact information

Practice address
334 NE IRVING AVE, STE 102, BEND, OR 97701-4710
(512) 736-6122
(541) 617-0377
Mailing address
334 NE IRVING AVE, STE 102, BEND, OR 97701-4710
(512) 736-6122
(541) 617-0377

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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