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Individual

DR. BRUCE PATTON MINDRUP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
106 GOODRICH ST, JERSEYVILLE, IL 62052-2212
(618) 498-4911
(618) 498-4921
Mailing address
106 GOODRICH ST, JERSEYVILLE, IL 62052-2212
(618) 498-4911
(618) 498-4921

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
IL

Other

Enumeration date
07/20/2006
Last updated
07/08/2007
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