Individual
ALEC BALLESTEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 456-0857
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 456-0857
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
2084P0800X
Psychiatry Physician
Primary
5151015439
MI
Other
Enumeration date
02/09/2015
Last updated
05/25/2022
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