Komor, Christian Robert

Komor, Christian Robert is an sole proprietor health care provider with primary practice located at 235 Louis St Nw , Grand Rapids MI 49503-2600. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Komor, Christian Robert can be contacted via phone (616) 706-6951.

Contact Information

Primary practice address
235 Louis St Nw Grand Rapids MI 49503-2600
Phone: (616) 706-6951
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 6301005480 Michigan

Profile Details

NPI number 1225409220
LBN Legal business name Komor, Christian Robert
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 15th, 2015
Last updated Sep 14th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225409220 NPPES
Michigan Other M032644 CHAMPUS
Michigan MEDICAID OD14598 CHAMPUS

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