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General NPI Number Information
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NPI Number | 1528443918
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Entity Type | Individual
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Provider Name | CHRIS COMRIE ATC
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Gender | Male
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 11/05/2023
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Provider Practice Location Address
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Address Line | 8 AUTUMN LEAVES DR
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City | LAKE SAINT LOUIS
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State | MO
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Zip | 63367-6436
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Country | US
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Telephone | 314-495-5748
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Fax |
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Provider Business Mailing Address
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Address Line | 8 AUTUMN LEAVES DR
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City | LAKE SAINT LOUIS
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State | MO
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Zip | 63367-6436
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Country | US
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Telephone | 314-495-5748
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 0001464
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License Number State | CO
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