Organization
VIRACH ANANTACHAI MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRACH ANANTACHAI MD (PRESIDENT)
(308) 745-0514
Entity
Organization
Contact information
Practice address
130 N 6TH STREET, LOUP CITY, NE 68853-0527
(308) 745-0514
Mailing address
PO BOX 527, 130 N 6TH STREET, LOUP CITY, NE 68853-0527
(308) 745-0514
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13217
NE
Other
Enumeration date
09/12/2006
Last updated
04/20/2008
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