Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Sandra Marie Pettiford, PT

Individual provider Physical Therapist · NPI 1710192703

Mrs. Sandra Marie Pettiford, PT is a Physical Therapist in East Saint Louis, Illinois. Practices as a sole proprietor. Licensed in Illinois, Indiana and Missouri.

Licensed in
IL, IN, MO
In the registry since
2007
Specialties on file
3
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

1005 State St
East Saint Louis, IL 62201-1907
Phone: (618) 646-3960
Fax: (618) 646-3968
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X (IL)
Physical Therapist Taxonomy 225100000X · Licence 05000547A (IN)
Physical Therapist Taxonomy 225100000X · Licence R0055 (MO)

Record details

NPI number1710192703
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorYes
NPI enumeratedMay 11, 2007
Last updated in NPPESJuly 8, 2007

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