CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC NPI 1801421656

NPI Information

CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC is a multi-specialty clinic center in Phoenix, AZ. CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC NPI is 1801421656. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Cleanslate Centers- North 40th Phoenix, Az..

The provider's business location address is:

15255 N 40TH ST STE 135
PHOENIX, AZ
ZIP 85032-682
Phone: (480) 417-4215

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.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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