OrganizationActive
Preventive Healthcare Technologies LLC
NPI 1497378145 · Physiological Laboratory · Wixom, MI
Provider details
- NPI number
- 1497378145
- Entity type
- Organization
- Primary specialty
- Physiological LaboratoryLaboratories
- Organization subpart
- No
- Authorized official
- Dominic Siwik, Ceo(833) 463-9633
Specialties & taxonomies
Laboratories
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
29560 Beck Rd
Wixom, MI 48393-2883
Phone: (833) 463-9633
Street-level locationGet directions
Mailing address
29560 Beck Rd
Wixom, MI 48393-2883
Additional practice locations (2)
- 6047 Tyvola Glen CirCharlotte, NC 28217-6431Phone: (313) 655-5400
- 201 Sigma Dr Ste 300Summerville, SC 29486-7722Phone: (313) 655-5400
Registry dates
- Enumerated
- 2020-05-28
- Last updated
- 2023-04-24
- Certified
- 2023-04-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.