Provider Demographics
NPI:1356706899
Name:TODD D. COMER, DC
Entity type:Organization
Organization Name:TODD D. COMER, DC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:D
Authorized Official - Last Name:COMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-600-4345
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:BUILDING A
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-29
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007167L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA273045OtherHIGHMARK
PA0547534000OtherIBC HMO ID
PAU71586Medicare UPIN
PA273045OtherHIGHMARK