OrganizationActive
Cleanslate Medical Group of Pennsylvania LLC
NPI 1184177263 · Multi-Specialty Clinic/Center · Wilkes Barre, PA
Provider details
- NPI number
- 1184177263
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Matthew Smolarek, Cfo(412) 999-5188
Specialties & taxonomies
Ambulatory Health Care Facilities
Allopathic & Osteopathic Physicians
Practice location
100 N Wilkes Barre Blvd Ste 103
Wilkes Barre, PA 18702-5240
Phone: (413) 584-2173
Fax: (833) 279-7074
Approximate (ZIP-level) locationGet directions
Mailing address
8 Cadillac Dr Ste 300
Brentwood, TN 37027-5337
Registry dates
- Enumerated
- 2016-07-26
- Last updated
- 2025-12-17
- Certified
- 2025-12-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.