Provider Demographics
NPI:1487847034
Name:COMFORT REHAB PA
Entity Type:Organization
Organization Name:COMFORT REHAB PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:469-272-7000
Mailing Address - Street 1:950 E BELT LINE RD
Mailing Address - Street 2:#180
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2422
Mailing Address - Country:US
Mailing Address - Phone:469-272-7000
Mailing Address - Fax:469-272-3069
Practice Address - Street 1:950 E BELT LINE RD
Practice Address - Street 2:#180
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2422
Practice Address - Country:US
Practice Address - Phone:469-272-7000
Practice Address - Fax:469-272-3069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9421111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty