Organization
CREATIVE PSYCHOPHARMACOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE BRUESKE (OFFICE MANAGER)
(612) 333-9954
Entity
Organization
Contact information
Practice address
701 25TH AVE S, #303, MINNEAPOLIS, MN 55454-1513
(612) 333-9954
(612) 333-9969
Mailing address
701 25TH AVE S, #303, MINNEAPOLIS, MN 55454-1513
(612) 333-9954
(612) 333-9969
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
9076412
MN
Other
Enumeration date
10/19/2007
Last updated
10/19/2007
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