Individual
MS. LISA OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1510 FREMONT ST, ALGOMA, ALGOMA, WI 54201
(920) 487-3676
Mailing address
512 KIRKLAND AVE, ALGOMA, ALGOMA, WI 54201-1075
(262) 758-1078
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.003393
IL
363A00000X
Physician Assistant
—
—
Other
Enumeration date
01/11/2006
Last updated
01/07/2009
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