NPI: 1245865096
Provider Name: CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC
Doing Business As: CLEANSLATE CENTERS- WEST THOMAS PHOENIX, AZ
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization
Specialization: Multi-Specialty
Address:
8410 W THOMAS RD STE 124
PHOENIX, AZ
ZIP 85037
Phone: (480) 417-5289
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CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC is a multi-specialty clinic center in Phoenix, AZ. CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC NPI is 1245865096. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Cleanslate Centers- West Thomas Phoenix, Az.
The provider's business location address is:
8410 W THOMAS RD STE 124
PHOENIX, AZ
ZIP 85037-373
Phone: (480) 417-5289
The provider's authorized official is Jessica Amick .
The authorized official title is Ao and has the following contact phone number (727) 798-8160.
The enumeration date for this NPI number is 3/11/2020 and was last updated on 3/23/2023.