Individual
PATRICK OLISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
55 WHITCHER ST NE STE 160, MARIETTA, GA 30060-1160
(770) 422-1372
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7242
GA
363A00000X
Physician Assistant
PA2016-0024
NM
Other
Enumeration date
07/21/2014
Last updated
11/12/2024
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