MEDICARE: DR. SANDRA LYNN FENCHEL JONES ND, DOM

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	171100000X	Acupuncturist	DOM1231	NM
2	175F00000X	Naturopath	ND-0008	NM

General Provider Information

NPI Number	:	1366490385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANDRA LYNN FENCHEL JONES ND, DOM

Provider Business Mailing Address
First Line	:	810 DALRYMPLE RD.
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88007
Country	:	US
Telephone Number	:	575-523-8517
Fax Number	:	575-904-7287

Provider Business Practice Location Address
First Line	:	810 DALRYMPLE RD.
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88007
Country	:	US
Telephone Number	:	575-523-8517
Fax Number	:	575-904-7287

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	12/09/2022

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