Provider Demographics
NPI:1023542198
Name:PRECISION NEUROTECHS LLC
Entity type:Organization
Organization Name:PRECISION NEUROTECHS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:TREAVOR
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:ERNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-983-9246
Mailing Address - Street 1:PO BOX 26145
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-0045
Mailing Address - Country:US
Mailing Address - Phone:410-983-9246
Mailing Address - Fax:410-995-2124
Practice Address - Street 1:307 S HENRY ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-5900
Practice Address - Country:US
Practice Address - Phone:410-983-9246
Practice Address - Fax:410-995-2124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty