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General NPI Number Information
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NPI Number | 1386663623
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Entity Type | Individual
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Provider Name | RICHARD OBERG MSOM
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3051 CAHILL MAIN
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City | FITCHBURG
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State | WI
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Zip | 53711-7109
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Country | US
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Telephone | 608-661-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 1265 JOHN Q HAMMONS DR
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City | MADISON
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State | WI
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Zip | 53717-1941
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Country | US
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Telephone | 608-251-4156
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Fax | 608-257-3842
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 446
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License Number State | WI
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