# THERA-PEDS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962878488
- **Authorized official:** LAURA PEREGOY OTR/L (MANAGER)
- **Authorized official phone:** (573) 259-1425

## Contact information

- **Practice address:** 115 PROGRESS PKWY, SULLIVAN, MO 63080-2359
- **Practice address phone:** (573) 468-3373
- **Mailing address:** 10276 TIMMERMANN LN, SULLIVAN, MO 63080-6436

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/19/2015
- **Last updated:** 12/29/2015