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General NPI Number Information
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NPI Number | 1104572494
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Entity Type | Organization
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Legal Business Name | ERICA JURAS OD, LLC
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Dates
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Enumeration Date | 02/24/2022
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 3951 W ASHLEY CIR
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City | CHARLESTON
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State | SC
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Zip | 29414-9156
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Country | US
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Telephone | 843-718-4131
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Fax | 843-806-2898
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Provider Business Mailing Address
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Address Line | 815 JEB STUART RD
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City | CHARLESTON
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State | SC
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Zip | 29412-9161
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Country | US
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Telephone | 843-718-4131
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERICA RYAN JURAS
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Credential |
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Telephone | 443-223-3447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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