| Street | Mueang Khon Kaen District | ||
| City/Town | ขอนแก่น | ||
| State/Province/Region | จังหวัดขอนแก่น | ||
| Zip/Postal Code | 40002 | ||
| Phone Number | 043 202 260 | ||
| Country | Thailand |
| Full Name | Prof. Juwan Feest MD | ||
| Gender | male | ||
| Birthday | 1972-05-03 | ||
| Social Security Number |
| Credit card brand | Voyager | ||
| Credit card number | 8699707614165933 | ||
| Expire | 2027/8 | ||
| CVV | 794 |