Provider Demographics
NPI:1720880420
Name:FIVE BRANCH HEALTH & WELLNESS LLC
Entity type:Organization
Organization Name:FIVE BRANCH HEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:352-740-0566
Mailing Address - Street 1:1216 NW 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-3475
Mailing Address - Country:US
Mailing Address - Phone:850-524-9030
Mailing Address - Fax:
Practice Address - Street 1:1216 NW 22ND AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-3475
Practice Address - Country:US
Practice Address - Phone:850-524-9030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty