Organization
NEUROTECH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS BLANK (CONTRACTING & CREDENTIALING MANAGER)
(262) 875-6575
Entity
Organization
Contact information
Practice address
2830 RAMADA WAY STE 204, GREEN BAY, WI 54304-5700
(866) 374-7648
Mailing address
626 W MORELAND BLVD, WAUKESHA, WI 53188-2433
(262) 875-6572
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
06/28/2018
Last updated
09/03/2024
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