Neurotech, LLC
Physiological Laboratory in Green Bay, WI. Organization (NPI-2).
NPI number1336780717
StatusActive
Last updated in NPPESNov 12, 2021
Details
- NPI
- 1336780717
- Entity type
- Organization (NPI-2)
- Legal business name
- Neurotech, LLC
- Organization subpart
- No
- Enumeration date
- Oct 7, 2019
- Certification date
- Nov 12, 2021
- Last updated
- Nov 12, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 293D00000X | Physiological Laboratory | – | – | Yes |
| 2472E0500X | Technician, Other, EEG | – | – | |
| 261QS1200X | Clinic/Center, Sleep Disorder Diagnostic | – | – | |
| 335V00000X | Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | – | – |
Other names
- Neurotech, LLC Fixed Idtf (Other Name)
Practice location
1263 Main St Ste 120Green Bay, WI 54302-1341
Phone 262-875-6612
Mailing address
3232 Ridge RdSuite 5
Lansing, IL 60438-3127
Phone 708-889-6096
Authorized official
Kristine Lisa Wildner
Director Of Contracting & Research
2628756572
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Physiological Laboratory providers in Green Bay, WI
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.