Graduated: 2018
NPI: 1730662982
Practice Locations (2)
CLEANSLATE MEDICAL GROUP OF WISCONSIN SC
377 W RIVER WOODS PKWY, SUITE 201
GLENDALE, WI 532121088
4143236880
CLEANSLATE MEDICAL GROUP OF WISCONSIN SC
101 E MILWAUKEE ST, SUITE 315
JANESVILLE, WI 535453002
8335054673
Source: CMS National Downloadable File, September 2026.