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Organization

DON SEALOCK, O.D., P.A.

Active
Parent organization
DON SEALOCK, O.D., P.A.
Other names
Four Seasons Eyecare - Maple Grove
Organization subpart
Yes

Provider details

NPI number
Legal business name
DON SEALOCK, O.D., P.A.
Authorized official
JENNIE J SEALOCK (SECR/TREAS)
(763) 559-7358
Entity
Organization

Contact information

Practice address
9825 HOSPITAL DR # 106, MAPLE GROVE, MN 55369-4479
(763) 568-7177
(763) 568-7361
Mailing address
4455 HIGHWAY 169 N, PLYMOUTH, MN 55442-2897
(763) 559-7358
(763) 559-6010

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary

Other

Enumeration date
02/06/2019
Last updated
02/06/2019
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