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Individual

TERRY H GILLENWATER

Active
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Individual

TERRY H GILLENWATER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104000276
VA
111N00000X
Chiropractor
4533746
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080269
BCBS VA
VA
01
—
23987
BCBS TN
TN
01
—
4576252
AETNA
—
01
—
5483793
CIGNA
—
Enumeration date
09/07/2006
Last updated
05/24/2021
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