Individual
EARL JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22 ZERKEL ST, LURAY, VA 22835-1913
(540) 843-3220
(540) 843-0248
Mailing address
22 ZERKEL ST, LURAY, VA 22835-1913
(540) 843-3220
(540) 843-0248
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9144
LURAY SCOOTER STORE, EQUIPMENT PROVIDER
VA
Enumeration date
07/18/2015
Last updated
07/18/2015
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