Provider Demographics
NPI:1063652774
Name:BOHLMANN, TIFFANY ANN (DVM)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:ANN
Last Name:BOHLMANN
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:702 N. JEFFERSON ST.
Mailing Address - City:WATSEKA
Mailing Address - State:IL
Mailing Address - Zip Code:60970-0159
Mailing Address - Country:US
Mailing Address - Phone:815-432-4624
Mailing Address - Fax:815-432-0112
Practice Address - Street 1:702 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WATSEKA
Practice Address - State:IL
Practice Address - Zip Code:60970-1133
Practice Address - Country:US
Practice Address - Phone:815-432-4624
Practice Address - Fax:815-432-0112
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL090.009627174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian