Individual
ALDAN WORTHY JAMES RACE I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5979 DESERT STORM AVE, FORT CAMPBELL, KY 42223-5514
(270) 798-4677
Mailing address
1805 PINTO CT, CLARKSVILLE, TN 37042-3422
(518) 653-8695
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0000005609
TN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/29/2023
Last updated
05/23/2024
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