Organization
NEUROTECH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER BLANK (CONTRACTING & CREDENTIALING MANAGER)
(262) 875-6575
Entity
Organization
Contact information
Practice address
6627 S 191ST PL STE F110, KENT, WA 98032-2118
(866) 374-7648
Mailing address
626 W MORELAND BLVD, WAUKESHA, WI 53188-2433
(262) 754-0898
(262) 754-0897
Taxonomy
Speciality
Code
Description
License number
State
246ZE0500X
EEG Specialist/Technologist
Primary
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
293D00000X
Physiological Laboratory
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356776322
—
WA
Enumeration date
09/10/2013
Last updated
03/12/2025
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