MEDICARE: MS. ELAINE S COMER PT

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	23050003032	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619950334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELAINE S COMER PT

Provider Business Mailing Address
First Line	:	PO BOX 5982
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23471-0982
Country	:	US
Telephone Number	:	757-547-7554
Fax Number	:	757-548-0647

Provider Business Practice Location Address
First Line	:	637 KINGSBOROUGH SQ
Second Line	:	SUITES F&G
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-4944
Country	:	US
Telephone Number	:	757-754-7755
Fax Number	:	757-548-0647

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

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	10/22/2010

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