Healthcare Provider Details

I. General information

NPI: 1467547513
Provider Name (Legal Business Name): STEPHEN KENT GREMMELS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 01/06/2014
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 TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number989
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: