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Search › Illinois › 225100000X

Sandra Pettiford, P. T

NPI 1710192703 · on the registry since 2007 · sole proprietor

Practice

Address
1005 State St
East Saint Louis, IL 62201
Phone
(618) 646-3960
Fax
(618) 646-3968
Organisation at this address
East St Louis Dist 189
Inferred from a shared address, not stated in the registry.
Clinicians at this address
2

Registry record

Primary taxonomy
225100000X
225100000X
Also registered as
225100000X
225100000X
Licence states on file
IN, MO, IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois