Healthcare Provider Details

I. General information

NPI: 1396830360
Provider Name (Legal Business Name): GREMMELS CHIROPRACTIC CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 01/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 CENTER POINT PKWY
BIRMINGHAM AL
35215-5505
US

IV. Provider business mailing address

1705 CENTER POINT PKWY
BIRMINGHAM AL
35215-5505
US

V. Phone/Fax

Practice location:
  • Phone: 205-854-3008
  • Fax: 205-854-0242
Mailing address:
  • Phone: 205-854-3008
  • Fax: 205-854-0242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number989
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2152
License Number StateAL

VIII. Authorized Official

Name: DR. STEPHEN KENT GREMMELS
Title or Position: OWNER
Credential: D.C.
Phone: 205-854-3008