Organization
PLYMOUTH VISION CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TATE HERMAN OD (OWNER)
(763) 559-4669
Entity
Organization
Contact information
Practice address
3007 HARBOR LN N STE 1500, PLYMOUTH, MN 55447-5103
(763) 559-4669
(763) 559-4767
Mailing address
3007 HARBOR LN N STE 1500, PLYMOUTH, MN 55447-5103
(763) 559-4669
(763) 559-4767
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16F68PL
BS OF MN
MN
Enumeration date
01/31/2007
Last updated
10/10/2022
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