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1558800193
CLEANSLATE MEDICAL GROUP OF OHIO LLC
DAYTON, OH
NPI
1558800193
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Entity Type
Organization
Authorized Contact
MATTHEW PHILIP SMOLAREK
CFO
412-999-5188
Organization Subpart ?
No
Primary Taxonomy
207RA0401X Internal Medicine, Addiction Medicine
Enumeration Date
2017-02-15
Last Update Date
2024-07-03
Business Address
CLEANSLATE MEDICAL GROUP OF OHIO LLC
1332 WOODMAN DR
DAYTON, OH 45432-3439
Phone number: 937-242-6710
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Mailing Address
CLEANSLATE MEDICAL GROUP OF OHIO LLC
8 CADILLAC DR STE 180
BRENTWOOD, TN 37027-5393
Phone number: 615-425-0220
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