Provider Demographics
NPI:1346021599
Name:HUMMEL, SHELBY (DC)
Entity Type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:
Last Name:HUMMEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 OZARK TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:ELLISVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63011-2160
Mailing Address - Country:US
Mailing Address - Phone:636-394-2225
Mailing Address - Fax:636-220-9115
Practice Address - Street 1:355 OZARK TRAIL DR
Practice Address - Street 2:
Practice Address - City:ELLISVILLE
Practice Address - State:MO
Practice Address - Zip Code:63011-2160
Practice Address - Country:US
Practice Address - Phone:636-394-2225
Practice Address - Fax:636-220-9115
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022015001111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor