Provider Demographics
NPI:1972871028
Name:COMER-CHRISTOPHER, MELANIE ROCHELLE
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:ROCHELLE
Last Name:COMER-CHRISTOPHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E LEWIS AND CLARK PKWY
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47129-1724
Mailing Address - Country:US
Mailing Address - Phone:812-944-4466
Mailing Address - Fax:812-941-9749
Practice Address - Street 1:220 E LEWIS AND CLARK PKWY
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-1724
Practice Address - Country:US
Practice Address - Phone:812-944-4466
Practice Address - Fax:812-941-9749
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26016857A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist