| NPI | 1932070612 |
|---|---|
| Doing Business As | AJ DIRECT CARE AND WELLNESS CLINIC |
| Entity Type | Organization |
| Authorized Contact | PANISSARA NATALIE TEERAANUKUL Provider 725-250-8697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-09-15 |
| Last Update Date | 2025-09-15 |