Individual
VATANA C. BOONYASAI
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D/
Contact information
Practice address
200 ST.MARY'S STREET, LOWER LEVEL, PILOT KNOB, MO 63650
(573) 546-3929
(573) 546-3962
Mailing address
PO BOX 527, PILOT KNOB, MO 63663-0527
(573) 546-3929
(573) 546-3962
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33968
MO
Other
Enumeration date
03/23/2006
Last updated
07/08/2007
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