Organization
PREVENTIVE HEALTHCARE TECHNOLOGIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIC H SIWIK (CEO)
(833) 463-9633
Entity
Organization
Contact information
Practice address
29560 BECK RD, WIXOM, MI 48393-2883
(833) 463-9633
Mailing address
29560 BECK RD, WIXOM, MI 48393-2883
(833) 463-9633
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
05/28/2020
Last updated
04/24/2023
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