Provider Demographics
NPI:1265950059
Name:SHELDEN, ZOE ALEXIS (DC)
Entity type:Individual
Prefix:DR
First Name:ZOE
Middle Name:ALEXIS
Last Name:SHELDEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ZOE
Other - Middle Name:ALEXIS
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1413 JONES CIRCLE
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:IA
Mailing Address - Zip Code:51546
Mailing Address - Country:US
Mailing Address - Phone:712-435-4232
Mailing Address - Fax:712-435-4232
Practice Address - Street 1:202 EAST 7TH STREET
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:IA
Practice Address - Zip Code:51546-1349
Practice Address - Country:US
Practice Address - Phone:712-435-4232
Practice Address - Fax:712-435-4232
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-01
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017031033111N00000X
IA097551111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor