Modern Ketamine Clinic
NPI #1386366532 in Maple Grove, Minnesota
Provider Information
- NPI Number
- 1386366532
- Entity Type
- Organization
- Organization Name
- Modern Ketamine Clinic
- Primary Specialty
- Clinic/Center - Infusion Therapy
- Enumeration Date
- Sep 14, 2022
- Last Updated
- May 28, 2025
Practice Location
- Address
- 13792 REIMER DR N
- City
- Maple Grove
- State
- Minnesota
- ZIP Code
- 55311-2219
- Phone
- (763) 347-2100
Authorized Official
- Name
- DANIEL GREGORY FALVEY, MD
- Title
- MD
- Phone
- (763) 347-2100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Multi-Specialty — Multi-Specialty |
| Clinic/Center - Infusion Therapy — Infusion Therapy |
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