Individual
MR. DERRICK PRATTE OLZACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1775 THIRD ST, ATWATER, CA 95301-3608
(209) 358-5611
(209) 358-0219
Mailing address
1775 3RD ST, ATWATER, CA 95301-3608
(209) 358-5611
(209) 358-0219
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
54432
CA
Other
Enumeration date
06/07/2017
Last updated
07/21/2022
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