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Organization

THERAFUN LLC

Active
Other names
Therafunction Inc DBA TheraFun
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LANA J RISTAU (CO-OWNER)
(405) 202-4112
Entity
Organization

Contact information

Practice address
1201 W. BOYD ST., NORMAN, OK 73069-4801
(405) 366-7898
(405) 366-0010
Mailing address
1201 W. BOYD ST., NORMAN, OK 73069-4801
(405) 366-7898
(405) 366-0010

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OK
235Z00000X
Speech-Language Pathologist
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100746270A
OK
Enumeration date
07/02/2006
Last updated
06/07/2022
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