MEDICARE: DESERT SKY OSTEOPATHY

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	204D00000X	Neuromusculoskeletal Medicine & OMM Physician

General Provider Information

NPI Number	:	1699524272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESERT SKY OSTEOPATHY

Provider Business Mailing Address
First Line	:	1208 PRINCETON DR SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-3019
Country	:	US
Telephone Number	:	505-346-7656
Fax Number	:

Provider Business Practice Location Address
First Line	:	1208 PRINCETON DR SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-3019
Country	:	US
Telephone Number	:	505-346-7656
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MEGAN SUSANNE SOFKA
Credential	:	DO
Telephone Number	:	505-346-7656

Provider Enumeration Date	:	05/15/2024
Last Update Date	:	05/15/2024

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Directions to “DESERT SKY OSTEOPATHY ” Practice Location

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