Organization
DON SEALOCK, O.D., P.A.
Active
Other names
Four Seasons Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD H SEALOCK O.D. (PRESIDENT)
(763) 559-7358
Entity
Organization
Contact information
Practice address
4455 HIGHWAY 169 N, PLYMOUTH, MN 55442-2897
(763) 559-7358
(763) 559-2167
Mailing address
4455 HIGHWAY 169 N, PLYMOUTH, MN 55442-2897
(763) 559-7358
(763) 559-2167
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2103
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
496562100
—
MN
Enumeration date
07/04/2006
Last updated
09/26/2016
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