Organization
NEUROTECH, LLC
Active
Parent organization
NEUROTECH, LLC
Other names
Neurotech Kentucky
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEUROTECH, LLC
Authorized official
KRISTINE LISA WILDNER (DIRECTOR OF CONTRACTING & RESEARCH)
(262) 875-6572
Entity
Organization
Contact information
Practice address
4010 DUPONT CIR STE 230, LOUISVILLE, KY 40207-4847
(262) 875-6635
Mailing address
626 W MORELAND BLVD, WAUKESHA, WI 53188-2433
(262) 754-0898
Taxonomy
Speciality
Code
Description
License number
State
246ZE0500X
EEG Specialist/Technologist
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
293D00000X
Physiological Laboratory
Primary
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
—
Other
Enumeration date
05/18/2015
Last updated
06/10/2020
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