Organization
TEGA CAY EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY F JERGE OD (OPTOMETRIST OWNER)
(803) 802-4733
Entity
Organization
Contact information
Practice address
1151 STONECREST BLVD, TEGA CAY, SC 29708
(803) 802-4733
(803) 802-4735
Mailing address
600 PINE LINKS DR, TEGA CAY, SC 29704-7205
(803) 802-4733
(803) 802-4735
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1468
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D14688
—
SC
Enumeration date
04/02/2008
Last updated
02/20/2013
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