NPI 1568238343

Bobby Self

Practitioner Driver Boonville, MO

Practice location

Address: 1728 Jesse James CT, Boonville, MO 65233-2874
Phone: (573) 540-7160

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence D135089004 (MO)

Other Driver providers in Missouri →

Registry record

NPI: 1568238343
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Dec 2023
Record last updated: 1 Dec 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.