Provider Demographics
NPI:1699810002
Name:COMES, MARLYN CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:MARLYN
Middle Name:CHARLES
Last Name:COMES
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 1:450 SYNDICATE ST N
Mailing Address - Street 2:# 198
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4107
Mailing Address - Country:US
Mailing Address - Phone:651-659-9000
Mailing Address - Fax:651-659-9039
Practice Address - Street 1:450 SYNDICATE ST N
Practice Address - Street 2:# 198
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4107
Practice Address - Country:US
Practice Address - Phone:651-659-9000
Practice Address - Fax:651-659-9039
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3371111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor