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General NPI Number Information
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NPI Number | 1356215115
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Entity Type | Organization
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Legal Business Name | GR ACUTHERAPY
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Dates
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Enumeration Date | 10/03/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 3167 KALAMAZOO AVE SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49508-1475
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Country | US
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Telephone | 616-438-8881
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Fax |
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Provider Business Mailing Address
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Address Line | 13206 WOODROW AVE NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49534-1054
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Country | US
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Telephone | 616-438-8881
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | CHRISTIAN HENRY MULLETT
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Credential | L.AC
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Telephone | 616-438-8881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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