Individual
DAVID BRANDON GILLIAM
Active
Individual
DAVID BRANDON GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTDPTATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000007423
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4134236
BLUE CROSS BLUE SHIELD
TN
Enumeration date
11/03/2006
Last updated
05/28/2014
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