Provider Demographics
NPI:1942099023
Name:DURELL WELLNESS PLLC
Entity type:Organization
Organization Name:DURELL WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:DURELL
Authorized Official - Suffix:
Authorized Official - Credentials:MTOM, LAC
Authorized Official - Phone:616-828-9546
Mailing Address - Street 1:2815 MICHIGAN ST NE STE A
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-1266
Mailing Address - Country:US
Mailing Address - Phone:616-855-7718
Mailing Address - Fax:616-855-2977
Practice Address - Street 1:2815 MICHIGAN ST NE STE A
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-1266
Practice Address - Country:US
Practice Address - Phone:616-855-7718
Practice Address - Fax:616-855-2977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty