Buck Jack LLC
NPI #1063025138 in Colorado Springs, Colorado
Provider Information
- NPI Number
- 1063025138
- Entity Type
- Organization
- Organization Name
- Buck Jack LLC
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- Aug 28, 2020
- Last Updated
- Feb 28, 2024
Practice Location
- Address
- 2233 ACADEMY PL STE 200
- City
- Colorado Springs
- State
- Colorado
- ZIP Code
- 80909-1666
- Phone
- (719) 301-0002
Authorized Official
- Name
- TANNER DENN
- Title
- CREDENTIALING SPECIALIST
- Phone
- (719) 428-1840
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Analyst |
| Psychologist |
| Physical Therapist |
| Occupational Therapist |
| Speech-Language Pathologist |
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