Organization
CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC
Active
Other names
Cleanslate Centers- North 40th Phoenix, AZ.
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW PHILIP SMOLAREK (CFO)
(412) 999-5188
Entity
Organization
Contact information
Practice address
15255 N 40TH ST STE 135, PHOENIX, AZ 85032-4682
(480) 417-4215
(833) 279-7074
Mailing address
8 CADILLAC DR STE 300, BRENTWOOD, TN 37027-5337
(615) 425-0220
(833) 279-7074
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/11/2020
Last updated
12/01/2025
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