Individual
CAROLYN RUTH COOMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ASSOCIATES
Contact information
Practice address
1400 WINDSOR AVE, BRISTOL, TN 37620-2070
(423) 274-8100
(423) 274-8103
Mailing address
1167 SPRATLIN PARK DR, GRAY, TN 37615-6205
(423) 467-3600
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
07/02/2012
Last updated
07/02/2012
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