Provider Demographics
NPI:1902124860
Name:GILMER, JOSEPH JOSHUA (DC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JOSHUA
Last Name:GILMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 JONESBOROUGH WATERPLNT RD
Mailing Address - Street 2:
Mailing Address - City:LIMESTONE
Mailing Address - State:TN
Mailing Address - Zip Code:37681-3021
Mailing Address - Country:US
Mailing Address - Phone:423-542-3777
Mailing Address - Fax:423-543-1499
Practice Address - Street 1:401 N BOONE ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-5607
Practice Address - Country:US
Practice Address - Phone:423-928-2251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2432111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4269177OtherBLUECROSS BLUESHIELD OF TN