MEDICARE: MS. KAREN MICHELLE ROANE COMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255R0406X	Blind Rehabilitation Specialist/Technologist	22691	AZ

General Provider Information

NPI Number	:	1356086581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN MICHELLE ROANE COMS

Provider Business Mailing Address
First Line	:	PO BOX 38635
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23231-1135
Country	:	US
Telephone Number	:	804-404-5236
Fax Number	:

Provider Business Practice Location Address
First Line	:	3513 BRIEL ST UNIT 105
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-6855
Country	:	US
Telephone Number	:	804-404-5236
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2022
Last Update Date	:	05/02/2022

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