Provider Demographics
NPI:1518033455
Name:GILLIS CHIROPRACTIC II, LLC
Entity type:Organization
Organization Name:GILLIS CHIROPRACTIC II, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:GILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-818-0000
Mailing Address - Street 1:5991 CHANDLER COURT
Mailing Address - Street 2:SUITE B
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8077
Mailing Address - Country:US
Mailing Address - Phone:614-818-0000
Mailing Address - Fax:614-818-0011
Practice Address - Street 1:5991 CHANDLER COURT
Practice Address - Street 2:SUITE B
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8077
Practice Address - Country:US
Practice Address - Phone:614-818-0000
Practice Address - Fax:614-818-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GI0734213Medicare ID - Type Unspecified