Individual
MR. RICHARD GERARD OBLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA
Contact information
Practice address
13677 W MCDOWELL RD, GOODYEAR, AZ 85395-2635
(623) 882-1500
Mailing address
4037 E WHITE ASTER ST, PHOENIX, AZ 85044-6796
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
05PA1134
PA
Other
Enumeration date
03/17/2022
Last updated
03/17/2022
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