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Organization

NEUROTECH, LLC

Active
Other names
Neurotech, LLC Fixed IDTF
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTINE LISA WILDNER (DIRECTOR OF CONTRACTING & RESEARCH)
(262) 875-6572
Entity
Organization

Contact information

Practice address
1263 MAIN ST STE 120, GREEN BAY, WI 54302-1341
(262) 875-6612
Mailing address
3232 RIDGE RD, SUITE 5, LANSING, IL 60438-3127
(708) 889-6096

Taxonomy

Speciality
Code
Description
License number
State
2472E0500X
EEG Technician
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
293D00000X
Physiological Laboratory
Primary
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

Other

Enumeration date
10/07/2019
Last updated
11/12/2021
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