Pettiford, Sandra Marie
Pettiford, Sandra Marie is an sole proprietor health care provider with primary practice located at 1005 State St , East Saint Louis IL 62201-1907. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Pettiford, Sandra Marie can be contacted via phone (618) 646-3960.Contact Information
Primary practice address
1005 State St
East Saint Louis IL 62201-1907
Phone: (618) 646-3960
Fax: (618) 646-3968
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 05000547A | Indiana |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | R0055 | Missouri |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | Illinois |
Profile Details
| NPI number | 1710192703 |
|---|---|
| LBN Legal business name | Pettiford, Sandra Marie |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 11th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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