Provider Demographics
NPI:1366493553
Name:COMER, TODD (DC)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:
Last Name:COMER
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 1:1923 CORI LN
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3805
Mailing Address - Country:US
Mailing Address - Phone:215-600-4345
Mailing Address - Fax:
Practice Address - Street 1:1108 N BETHLEHEM PIKE
Practice Address - Street 2:SUITE 4
Practice Address - City:LOWER GWYNEDD
Practice Address - State:PA
Practice Address - Zip Code:19002-1423
Practice Address - Country:US
Practice Address - Phone:215-600-4345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-13
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007167L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0547534000OtherIBC HMO ID
PA273045OtherHIGHMARK BS
PAU71586Medicare UPIN
PA008544TSFMedicare PIN