Individual
KEVIN ALAN SVOBODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070012949
IL
225100000X
Physical Therapist
Primary
6069-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518923754
—
WI
01
—
859400081
MEDICARE
WI
01
—
P01161193
RAILROAD MEDICARE
WI
01
—
WI2660002
MEDICARE
WI
Enumeration date
04/25/2006
Last updated
04/21/2016
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