Individual
BOBBY VITAYA ENKVETCHAKUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 W 12TH ST, WASHINGTON, MO 63090-4416
(636) 239-0735
(636) 239-0907
Mailing address
PO BOX 1275, WASHINGTON, MO 63090-8275
(636) 239-0735
(636) 239-0907
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
MD113081 MO
MO
Other
Enumeration date
08/30/2006
Last updated
02/21/2024
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