Provider Demographics
NPI:1083061279
Name:GILLIAM, JOHN (DPT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:GILLIAM
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:76 PEACHTREE ROAD STE 204
Mailing Address - Street 2:ASHEVILLE PHYSICAL THERAPY
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803
Mailing Address - Country:US
Mailing Address - Phone:828-277-7547
Mailing Address - Fax:828-277-7540
Practice Address - Street 1:858 MERRIMON AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-2405
Practice Address - Country:US
Practice Address - Phone:828-552-4217
Practice Address - Fax:828-518-3416
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist