Healthcare Provider Details

I. General information

NPI: 1619894193
Provider Name (Legal Business Name): KEITH STANTON REMKE JR. ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: STAN REMKE ATC

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 CORPORATE DR STE 225
BIRMINGHAM AL
35242-2721
US

IV. Provider business mailing address

878 MCALLISTER DR
CALERA AL
35040-5521
US

V. Phone/Fax

Practice location:
  • Phone: 205-408-1713
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number313447
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: