Provider Demographics
NPI:1063171114
Name:APTIVA HEALTH & WELLNESS
Entity type:Organization
Organization Name:APTIVA HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HUHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-909-0772
Mailing Address - Street 1:10100 LINN STATION RD STE B
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3861
Mailing Address - Country:US
Mailing Address - Phone:502-812-1002
Mailing Address - Fax:877-299-2777
Practice Address - Street 1:10100 LINN STATION RD STE B
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-3861
Practice Address - Country:US
Practice Address - Phone:502-812-1002
Practice Address - Fax:877-299-2777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty