MEDICARE: DURELL WELLNESS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1942099023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DURELL WELLNESS PLLC

Provider Business Mailing Address
First Line	:	2815 MICHIGAN ST NE STE A
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49506-1266
Country	:	US
Telephone Number	:	616-855-7718
Fax Number	:	616-855-2977

Provider Business Practice Location Address
First Line	:	2815 MICHIGAN ST NE STE A
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49506-1266
Country	:	US
Telephone Number	:	616-855-7718
Fax Number	:	616-855-2977

Authorized Official
Title or Position	:	OWNER
Name	:	MR. STEPHEN MICHAEL DURELL
Credential	:	MTOM, LAC
Telephone Number	:	616-828-9546

Provider Enumeration Date	:	05/05/2025
Last Update Date	:	05/05/2025

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Directions to “DURELL WELLNESS PLLC ” Practice Location

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