Healthcare Provider Details

I. General information

NPI: 1841312105
Provider Name (Legal Business Name): SANDRA K. SCHANK D.O.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 5TH ST SUITE 207
SANTA FE NM
87505-5403
US

IV. Provider business mailing address

8 FIREROCK PL
SANTA FE NM
87508-1325
US

V. Phone/Fax

Practice location:
  • Phone: 505-670-2743
  • Fax:
Mailing address:
  • Phone: 505-473-3518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number498
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number173
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: