Provider Demographics
NPI:1073677563
Name:MINNEMAN, JOHN ADDISON (DVM)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ADDISON
Last Name:MINNEMAN
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 E POLK ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-1137
Mailing Address - Country:US
Mailing Address - Phone:319-653-5641
Mailing Address - Fax:
Practice Address - Street 1:119 E POLK ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IA
Practice Address - Zip Code:52353-1137
Practice Address - Country:US
Practice Address - Phone:319-653-5641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2902174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian