Individual
JERRY LEE EARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
226 SUMMIT AVE, MINGO JUNCTION, OH 43938-1352
(704) 470-7285
Mailing address
226 SUMMIT AVE, MINGO JUNCTION, OH 43938-1352
(704) 470-7285
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125553494
—
WV
05
—
1356607394
—
WV
05
—
1821206228
—
WV
Enumeration date
06/11/2025
Last updated
06/11/2025
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