Individual
JOHN ALLEN GILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1905 LATHAM AVE, LIMA, OH 45805-1637
(419) 228-0000
Mailing address
1905 LATHAM AVE, LIMA, OH 45805-1637
(419) 228-0000
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1226
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000181391
ANTHEM BLUE CROSS / BLUE SHIELD
OH
01
—
04754
PARAMOUNT
OH
01
—
31-1490432-004
MEDICAL MUTUAL
OH
01
—
4598779
AETNA
OH
Enumeration date
11/16/2006
Last updated
07/13/2022
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