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

Sandra Rae Divine, PTA

Individual provider Skilled Nursing Facility · NPI 1932507431

Sandra Rae Divine, PTA is a Skilled Nursing Facility in Stockton, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2014
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

1015 Lancaster Dr
Stockton, MO 65785-8360
Phone: (417) 276-4531
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X · Licence 115167 (MO)

Record details

NPI number1932507431
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorYes
NPI enumeratedDecember 15, 2014
Last updated in NPPESDecember 15, 2014
Mailing address1015 Lancaster Dr, Stockton, MO 65785-8360

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