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General NPI Number Information
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NPI Number | 1225098874
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Entity Type | Organization
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Legal Business Name | SINEK VISION CLINIC PC
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 330 N MAIN ST
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City | POCAHONTAS
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State | IA
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Zip | 50574-1626
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Country | US
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Telephone | 712-335-3298
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Fax | 712-335-3262
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Provider Business Mailing Address
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Address Line | 330 N MAIN ST
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City | POCAHONTAS
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State | IA
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Zip | 50574-1626
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Country | US
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Telephone | 712-335-3298
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Fax | 712-335-3262
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Authorized Official
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Title or Position | OPTOMETRIST PRESIDENT
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Name | DR. CHRISTOPHER DAVID RADIG
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Credential | OD
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Telephone | 712-335-3298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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