Organization · Type 2 NPI
Modern Ketamine Clinic
Infusion Therapy Clinic/Center · Maple Grove, MN
NPI number
1386366532
Active
Practice location
13792 Reimer Dr N
Maple Grove, MN 55311-2219
Fax (763) 333-7174
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Infusion Therapy Clinic/Center Primary | 261QI0500X | None listed |
| Multi-Specialty Clinic/Center | 261QM1300X | None listed |
Infusion Therapy Clinic/Center: Definition to come...
2 other providers at this address
About NPI 1386366532
Modern Ketamine Clinic's National Provider Identifier is 1386366532, issued on Sep 14, 2022. The primary taxonomy on file is Infusion Therapy Clinic/Center (261QI0500X), and the practice location is in Maple Grove, MN. The record was last updated on May 28, 2025.