Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SANDRA RAE DIVINE, P.T.A
Active Sole ProprietorSANDRA RAE DIVINE, P.T.A is a Skilled Nursing Facility healthcare provider located in STOCKTON, Missouri. NPI 1932507431 is currently active in the NPPES registry. Verify at CMS.
Skilled Nursing Facility · STOCKTON, MO
Registration Details
- NPI Number
- 1932507431
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 15, 2014 (11.482865865652 yrs)
- Last Updated
- Dec 15, 2014
- License
-
115167 (MO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1015 LANCASTER DRSTOCKTON, MO, 657858360Browse MO providers · Browse ZIP 65785
- Phone
- 4172764531
- Primary Specialty
-
Skilled Nursing Facility
314000000X
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.