Provider Demographics
NPI:1558408468
Name:COMEAU, BRETT MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:MICHAEL
Last Name:COMEAU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:BRETT
Other - Middle Name:MICHAEL
Other - Last Name:COMEAU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2290 US 70 HWY
Mailing Address - Street 2:
Mailing Address - City:SWANNANOA
Mailing Address - State:NC
Mailing Address - Zip Code:28778-8209
Mailing Address - Country:US
Mailing Address - Phone:828-686-5200
Mailing Address - Fax:828-686-0555
Practice Address - Street 1:2290 US 70 HWY
Practice Address - Street 2:
Practice Address - City:SWANNANOA
Practice Address - State:NC
Practice Address - Zip Code:28778-8209
Practice Address - Country:US
Practice Address - Phone:828-686-5200
Practice Address - Fax:828-686-0555
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3416111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0853XOtherBC/BS OF NORTH CAROLINA
NC5905950Medicaid
NC2459316Medicare PIN
NC0853XOtherBC/BS OF NORTH CAROLINA