Provider Demographics
NPI:1265652200
Name:SEVCIK, DEANNA (PT)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:SEVCIK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:
Other - Last Name:STROMSKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:123 HOSPITAL DR
Mailing Address - Street 2:SUITE1009
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53098-3331
Mailing Address - Country:US
Mailing Address - Phone:920-262-4504
Mailing Address - Fax:920-262-4501
Practice Address - Street 1:123 HOSPITAL DR
Practice Address - Street 2:SUITE1009
Practice Address - City:WATERTOWN
Practice Address - State:WI
Practice Address - Zip Code:53098-3331
Practice Address - Country:US
Practice Address - Phone:920-262-4504
Practice Address - Fax:920-262-4501
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5107225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist