Individual
JOHN O'LEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
W225N16711 CEDAR PARK CT, JACKSON, WI 53037-9222
(262) 677-1101
Mailing address
W225N16711 CEDAR PARK CT, JACKSON, WI 53037-9222
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7492-23
WI
Other
Enumeration date
05/31/2023
Last updated
07/10/2023
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