Provider Demographics
NPI:1386449049
Name:NEURON CONNECT LLC
Entity type:Organization
Organization Name:NEURON CONNECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEATTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-877-0127
Mailing Address - Street 1:2303 N 44TH ST STE 14-1428
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-2442
Mailing Address - Country:US
Mailing Address - Phone:602-888-1012
Mailing Address - Fax:602-926-8333
Practice Address - Street 1:4524 N MARYVALE PKWY STE 140
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-1730
Practice Address - Country:US
Practice Address - Phone:602-888-1012
Practice Address - Fax:602-926-8333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center