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Organization
NEUROTECH, LLC
Active
Organization
NEUROTECH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS BLANK (CONTRACTING & CREDENTIALING MANAGER)
(262) 875-6575
Entity
Organization
Contact information
Practice address
41800 HAYES RD STE 101, CLINTON TOWNSHIP, MI 48038-1876
(262) 754-0898
(262) 754-0897
Mailing address
626 W MORELAND BLVD, WAUKESHA, WI 53188-2433
(262) 875-6575
(262) 754-0897
Taxonomy
Speciality
Code
Description
License number
State
2472E0500X
EEG Technician
—
NULL
2472E0500X
EEG Technician
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
NULL
293D00000X
Physiological Laboratory
—
NULL
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
NULL
Other
Enumeration date
01/29/2019
Last updated
10/31/2024
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