DISNEY KULACHATI SAMUTSAKORN

FORT BRAGG, NC
NPI1255875571
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: NC  1138817)
Enumeration Date2016-12-05
Last Update Date2025-04-01
Business Address
DISNEY KULACHATI SAMUTSAKORN PA-C
2817 ROCK MERRITT AVE
FORT BRAGG, NC 28310-4504
Phone number: 910-907-8922
Mailing Address
DISNEY KULACHATI SAMUTSAKORN PA-C
2817 REILLY ST
FORT BRAGG, NC 28310-7324
Phone number: 910-907-6000
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