# NEUROTECH, LLC

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

## Provider details

- **NPI number:** 1679064638
- **Authorized official:** KRISTINE LISA WILDNER (DIRECTOR OF CONTRACTING AND RESEARC)
- **Authorized official phone:** (262) 875-6572

## Contact information

- **Practice address:** 4609 MILL BRANCH LN, KNOXVILLE, TN 37938-3260
- **Practice address phone:** (865) 851-8354
- **Practice address fax:** (262) 754-0897
- **Mailing address:** 626 W MORELAND BLVD, WAUKESHA, WI 53188-2433
- **Mailing address phone:** (262) 754-0898
- **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 | Yes |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | NULL | — |

## Other

- **Enumeration date:** 05/25/2018
- **Last updated:** 03/09/2019