Provider Demographics
NPI:1962905075
Name:SHELTON, GABRIEL (DC)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:SHELTON
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3934 UNION RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125-4321
Mailing Address - Country:US
Mailing Address - Phone:314-620-5350
Mailing Address - Fax:
Practice Address - Street 1:3934 UNION RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-4321
Practice Address - Country:US
Practice Address - Phone:314-620-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025005541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2025005541OtherMISSOURI BOARD OF CHIROPRACTIC EXAMINERS