Provider Demographics
NPI:1568738243
Name:CONGDON, JONATHAN M (MS DVM DACVA)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:M
Last Name:CONGDON
Suffix:
Gender:M
Credentials:MS DVM DACVA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 BLUEMOUND ROAD
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188
Mailing Address - Country:US
Mailing Address - Phone:262-542-3241
Mailing Address - Fax:
Practice Address - Street 1:360 BLUEMOUND RD
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1752
Practice Address - Country:US
Practice Address - Phone:262-542-3241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6718-50174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian