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Individual

DR. DIANE JURAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
605 SAINT JAMES AVE, GOOSE CREEK, SC 29445-2758
(843) 863-1215
(843) 553-7335
Mailing address
PO BOX 23, ISLE OF PALMS, SC 29451-0023
(843) 693-2505
(843) 216-0066

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0956
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
D09569
SC
01
P00435798
RR MEDICARE
SC
Enumeration date
05/04/2006
Last updated
05/14/2008
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