MEDICARE: SINEK VISION CLINIC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0416820001	OTHER	DMERC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0416820002	OTHER	DMERC
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	0416820003	OTHER	DMERC

General Provider Information

NPI Number	:	1467429902
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SINEK VISION CLINIC PC

Provider Business Mailing Address
First Line	:	411 4 STREET
Second Line	:
City	:	ROCKWELL CITY
State	:	IA
Zip	:	50579-1413
Country	:	US
Telephone Number	:	712-297-8607
Fax Number	:	712-297-7045

Provider Business Practice Location Address
First Line	:	411 4 STREET
Second Line	:
City	:	ROCKWELL CITY
State	:	IA
Zip	:	50579-1413
Country	:	US
Telephone Number	:	712-297-8607
Fax Number	:	712-297-7045

Authorized Official
Title or Position	:	OPTOMETRIST PRESIDENT
Name	:	DR. CHRISTOPHER DAVID RADIG
Credential	:	OD
Telephone Number	:	712-335-3298

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	11/06/2007

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Directions to “SINEK VISION CLINIC PC ” Practice Location

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