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Contact Information

GRAND WELLNESS, LLC
751 KENMOOR AVE SE STE H
GRAND RAPIDS, MI49546-2391
 Phone: 616-466-4175
 Fax: 616-259-4855
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acupuncturist

171100000X
Indicates primary specialty

NPI Profile & details for GRAND WELLNESS, LLC

NPI Number 1821465956
LBN Legal business name GRAND WELLNESS, LLC
Authorized official VIKKI NESTICO - (ACUPUNCTURIST)
Entity Organization
Organization subpart 1 No
Enumeration date 08/24/2015
Last updated 06/20/2021 - About 5 years ago
Identifiers
MI License # 5401000137
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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