Individual
TERRY H GILLENWATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2110 EUCLID AVE, BRISTOL, VA 24201
(276) 669-9158
(276) 669-6261
Mailing address
2110 EUCLID AVE, BRISTOL, VA 24201
(276) 669-9158
(276) 669-6261
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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