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Tyler Sealock

Optometrist in Plymouth, MN. Individual provider (NPI-1).

NPI number1013845643
StatusActive
Last updated in NPPESJun 29, 2026

Details

NPI
1013845643
Entity type
Individual (NPI-1)
Name
Tyler Sealock
Sex
Male
Sole proprietor
No
Enumeration date
May 13, 2026
Certification date
Jun 29, 2026
Last updated
Jun 29, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X Optometrist4060MNYes

Practice location

4455 Highway 169 N
Plymouth, MN 55442-2897

Phone 763-559-7358 · Fax 763-559-2167

Mailing address

4455 Highway 169 N
Plymouth, MN 55442-2897

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