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General NPI Number Information
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NPI Number | 1194289603
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Entity Type | Organization
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Legal Business Name | NEUROTECH, LLC
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Dates
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Enumeration Date | 01/29/2019
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 41800 HAYES RD STE 101
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-1876
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Country | US
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Telephone | 262-754-0898
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Fax | 262-754-0897
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Provider Business Mailing Address
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Address Line | 626 W MORELAND BLVD
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City | WAUKESHA
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State | WI
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Zip | 53188-2433
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Country | US
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Telephone | 262-875-6575
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Fax | 262-754-0897
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Authorized Official
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Title or Position | CONTRACTING & CREDENTIALING MANAGER
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Name | CHRIS BLANK
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Credential |
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Telephone | 262-875-6575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2472E0500X
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Taxonomy Name | EEG Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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