Organization
BRANCHOUT CLINICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMIAH GOLESH (BILLING MANAGER)
(801) 455-2687
Entity
Organization
Contact information
Practice address
5620 S WATERBURY WAY STE A200, SALT LAKE CITY, UT 84121-1180
(801) 455-8822
Mailing address
5620 S WATERBURY WAY STE A200, SALT LAKE CITY, UT 84121-1180
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/08/2023
Last updated
02/08/2023
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