Provider Demographics
NPI:1659348100
Name:SINEK VISION CLINIC PC
Entity Type:Organization
Organization Name:SINEK VISION CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:RADIG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:712-335-3298
Mailing Address - Street 1:1019 MAIN ST
Mailing Address - Street 2:PO 850
Mailing Address - City:MANSON
Mailing Address - State:IA
Mailing Address - Zip Code:50563-5156
Mailing Address - Country:US
Mailing Address - Phone:712-469-2592
Mailing Address - Fax:712-469-3002
Practice Address - Street 1:1019 MAIN ST
Practice Address - Street 2:
Practice Address - City:MANSON
Practice Address - State:IA
Practice Address - Zip Code:50563-5156
Practice Address - Country:US
Practice Address - Phone:712-469-2592
Practice Address - Fax:712-469-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-03
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0113910Medicaid
IA0116996Medicaid
0416820003OtherDMERC
0416820001OtherDMERC
0416820002OtherDMERC
IA2113910Medicaid
0416820002OtherDMERC
16910Medicare ID - Type Unspecified
IA2113910Medicaid
IA0113910Medicaid