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General NPI Number Information
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NPI Number | 1942099023
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Entity Type | Organization
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Legal Business Name | DURELL WELLNESS PLLC
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 2815 MICHIGAN ST NE STE A
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-1266
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Country | US
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Telephone | 616-855-7718
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Fax | 616-855-2977
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Provider Business Mailing Address
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Address Line | 2815 MICHIGAN ST NE STE A
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-1266
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Country | US
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Telephone | 616-855-7718
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Fax | 616-855-2977
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Authorized Official
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Title or Position | OWNER
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Name | MR. STEPHEN MICHAEL DURELL
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Credential | MTOM, LAC
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Telephone | 616-828-9546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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