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Organization

CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT HUTCHISON (CFO)
(615) 425-0220
Entity
Organization

Contact information

Practice address
8410 W THOMAS, PHOENIX, AZ 85037
(413) 584-2173
Mailing address
15 CENTURY BLVD STE 307, NASHVILLE, TN 37214-3692
(615) 425-0220

Taxonomy

Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary

Other

Enumeration date
01/25/2017
Last updated
07/02/2019
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