Provider Demographics
NPI:1902377955
Name:JAMMARON, SANDRA LYNNE
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:LYNNE
Last Name:JAMMARON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LYNNE
Other - Middle Name:
Other - Last Name:JAMMARON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:715 HORIZON DR STE 225
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6916 HIGHWAY 82
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-9435
Practice Address - Country:US
Practice Address - Phone:970-945-2583
Practice Address - Fax:970-928-8852
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist