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Individual

JEFFERY WAYNE COOMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRC, CFRC

Contact information

Practice address
52 E WASHINGTON AVE, PERU, IN 46970-1007
(765) 431-8114
Mailing address
52 E WASHINGTON AVE, PERU, IN 46970-1007
(765) 431-8114

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CARC-5030
IN
175T00000X
Peer Specialist
CFRC-5002
IN

Other

Enumeration date
04/22/2026
Last updated
04/22/2026
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