Provider Demographics
NPI:1952360836
Name:SVEC, ROGER WILLIAM (PT)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:WILLIAM
Last Name:SVEC
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 FIRETHORN TRL
Mailing Address - Street 2:
Mailing Address - City:DAKOTA DUNES
Mailing Address - State:SD
Mailing Address - Zip Code:57049-5237
Mailing Address - Country:US
Mailing Address - Phone:605-232-9341
Mailing Address - Fax:605-232-9341
Practice Address - Street 1:428 FIRETHORN TRL
Practice Address - Street 2:
Practice Address - City:DAKOTA DUNES
Practice Address - State:SD
Practice Address - Zip Code:57049-5237
Practice Address - Country:US
Practice Address - Phone:605-232-9341
Practice Address - Fax:605-232-9341
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE768225100000X
IA1584225100000X
SD08252251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0006267OtherMEDICARE BLUE PPO
SD5830864Medicaid
IA0006267OtherWELLMARK BCBS
SD0006267OtherWELLMARK BCBS