# GRAND WELLNESS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821465956
- **Authorized official:** MS. VIKKI NESTICO L. AC. (ACUPUNCTURIST)
- **Authorized official phone:** (917) 376-4001

## Contact information

- **Practice address:** 751 KENMOOR AVE SE STE H, GRAND RAPIDS, MI 49546-2391
- **Practice address phone:** (616) 466-4175
- **Practice address fax:** (616) 259-4855
- **Mailing address:** 1531 LAKE GROVE AVE SE, EAST GRAND RAPIDS, MI 49506-4741

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | 5401000137 | MI | Yes |

## Other

- **Enumeration date:** 08/24/2015
- **Last updated:** 06/20/2021