Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. SANDRA MARIE PETTIFORD, P. T.

Active Sole Proprietor

Physical Therapy Assistant · EAST SAINT LOUIS, IL

Registration Details

NPI Number: 1710192703
Provider Type: Individual
Gender: Female
NPI Issued: May 11, 2007 (18.981700978677 yrs)
Last Updated: Jul 8, 2007
Licenses: 05000547A (IN)

R0055 (MO)
Sole Proprietor: Yes

Practice Information

Address: 1005 STATE ST

EAST SAINT LOUIS, IL, 622011907
Browse IL providers · Browse ZIP 62201
Phone: 6186463960
Fax: 6186463968
Primary Specialty: Physical Therapy Assistant
225100000X
Additional Specialty: Physical Therapy Assistant
Additional Specialty: Physical Therapy Assistant

Other Physical Therapy Assistant Providers in EAST SAINT LOUIS, IL

Name	Credential	NPI
TONYA ACZINOWICZ	PT	1154545283
JEAN LAMMERS	PT	1659595783
JULIA HORN	DPT	1568020667

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.