Individual
AARON Q FORTENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA/RA
Contact information
Practice address
505 S JOHN REDDITT DR, LUFKIN, TX 75904-3120
(936) 637-8581
Mailing address
2510 COUNTY ROAD 2100, WOODVILLE, TX 75979-3419
(409) 331-9345
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
18475
TX
Other
Enumeration date
08/13/2009
Last updated
08/13/2009
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