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Cleanslate Medical Group Of Pennsylvania Llc
Multi-Specialty Clinic/Center in Wilkes Barre, Pennsylvania
NPI 1184177263

Cleanslate Medical Group Of Pennsylvania Llc is a Multi-Specialty Clinic/Center based in Brentwood, PA and is specialized in Multi-Specialty. Cleanslate Medical Group Of Pennsylvania Llc practices in Wilkes Barre, PA. The NPI Number for Cleanslate Medical Group Of Pennsylvania Llc is 1184177263 and holds a License No. (Pennsylvania).

The current practice location address for Cleanslate Medical Group Of Pennsylvania Llc is 100 N Wilkes Barre Blvd Ste 103, Wilkes Barre, PA and can be reached out via phone at 413-584-2173 and via fax at 413-727-3619.

Location: 100 N Wilkes Barre Blvd Ste 103, Wilkes Barre, PA, 37027-5393
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1184177263
Provider Name
Cleanslate Medical Group Of Pennsylvania Llc
Credential
Provider Entity Type
Organization
Address
100 N Wilkes Barre Blvd Ste 103, Wilkes Barre, PA, 37027-5393
Phone Number
413-584-2173
Fax Number
413-727-3619
Provider Enumeration Date
07/26/2016
Last Update Date
07/20/2024
institution
Provider Business Practice Location Address Details
Address
100 N Wilkes Barre Blvd Ste 103
City
Wilkes Barre
State
Pennsylvania
Zip
18702-5240
Phone Number
413-584-2173
Fax Number
413-727-3619
person
Provider Business Mailing Address Details
Address
100 N Wilkes Barre Blvd Ste 103
City
Wilkes Barre
State
Pennsylvania
Zip
18702-5240
Phone Number
413-584-2173
Fax Number
413-727-3619
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Addiction Medicine
Taxonomy
207RA0401X
License No.
()
Definition
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Multi-Specialty
Taxonomy
261QM1300X
License No.
()
Definition
Definition to come...
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