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General NPI Number Information
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NPI Number | 1841869880
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Entity Type | Individual
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Provider Name | GREGORY ROBERT SHELDON PT, ATC
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Gender | Male
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 9630 GROVE CIR N STE 200
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City | MAPLE GROVE
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State | MN
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Zip | 55369-3492
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Country | US
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Telephone | 763-520-7870
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 AMERICAN BLVD W STE 300
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City | BLOOMINGTON
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State | MN
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Zip | 55431-4442
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Country | US
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Telephone | 952-512-5600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 3200
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 12291
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License Number State | MN
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