MRS. Sandra Marie Pettiford, P. T.

NPI #1710192703 in East Saint Louis, Illinois

Provider Information

NPI Number: 1710192703
Entity Type: Individual
Name: MRS. Sandra Marie Pettiford, P. T.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Credential: P. T.
Enumeration Date: May 11, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1005 STATE ST
City: East Saint Louis
State: Illinois
ZIP Code: 62201-1907
Phone: (618) 646-3960

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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