# NEUROTECH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194289603
- **Authorized official:** CHRIS BLANK (CONTRACTING & CREDENTIALING MANAGER)
- **Authorized official phone:** (262) 875-6575

## Contact information

- **Practice address:** 41800 HAYES RD STE 101, CLINTON TOWNSHIP, MI 48038-1876
- **Practice address phone:** (262) 754-0898
- **Practice address fax:** (262) 754-0897
- **Mailing address:** 626 W MORELAND BLVD, WAUKESHA, WI 53188-2433
- **Mailing address phone:** (262) 875-6575
- **Mailing address fax:** (262) 754-0897

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |

## Other

- **Enumeration date:** 01/29/2019
- **Last updated:** 10/31/2024