MEDICARE: CALEB DEAN COMSTOCK

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	225100000X	Physical Therapist	5501304431	MI

General Provider Information

NPI Number	:	1366399123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALEB DEAN COMSTOCK

Provider Business Mailing Address
First Line	:	1098 BYRON ST APT G
Second Line	:
City	:	PLYMOUTH
State	:	MI
Zip	:	48170-2151
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	42727 FORD RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-3376
Country	:	US
Telephone Number	:	734-418-4866
Fax Number	:

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

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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Directions to “ CALEB DEAN COMSTOCK ” Practice Location

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