Organization
LORIS EYE ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY P. RAY O. D. (OWNER)
(843) 756-1262
Entity
Organization
Contact information
Practice address
3911 MAIN ST, LORIS, SC 29569-3017
(843) 756-1262
(843) 756-6667
Mailing address
3911 MAIN ST, LORIS, SC 29569-3017
(843) 756-1262
(843) 756-6667
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
860
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA9737
—
SC
Enumeration date
05/08/2007
Last updated
03/14/2024
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