Provider Demographics
NPI:1902017759
Name:COMER, KARLENE SUE (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:KARLENE
Middle Name:SUE
Last Name:COMER
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SATELLITE LN NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-4951
Mailing Address - Country:US
Mailing Address - Phone:763-571-8001
Mailing Address - Fax:
Practice Address - Street 1:101 SATELLITE LN NE
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-4951
Practice Address - Country:US
Practice Address - Phone:763-571-8001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist