MEDICARE: ROBERT JAMES SHELTON DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	02633	MN

General Provider Information

NPI Number	:	1255526208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT JAMES SHELTON DC

Provider Business Mailing Address
First Line	:	2800 CHICAGO AVENUE SOUTH
Second Line	:	#LL08
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407
Country	:	US
Telephone Number	:	612-879-9500
Fax Number	:	612-879-9504

Provider Business Practice Location Address
First Line	:	2800 CHICAGO AVENUE SOUTH
Second Line	:	#LL08
City	:	MPLS
State	:	MN
Zip	:	55407
Country	:	US
Telephone Number	:	612-879-9500
Fax Number	:	612-879-9504

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	09/12/2007

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