Individual
MR. CHARLES COMER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7300 W DEAN RD APT EAST173, MILWAUKEE, WI 53223-2604
(414) 882-1650
Mailing address
7300 W DEAN RD APT EAST173, MILWAUKEE, WI 53223-2604
(414) 882-1650
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
C5601538537808
WI
Other
Enumeration date
01/11/2022
Last updated
01/11/2022
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