Buck Jack, LLC

NPI #1073491429 in Pueblo, Colorado

Provider Information

NPI Number: 1073491429
Entity Type: Organization
Organization Name: Buck Jack, LLC
Primary Specialty: Occupational Therapist
Enumeration Date: Aug 25, 2025
Last Updated: Aug 25, 2025

Practice Location

Address: 4025 CLUB MANOR DR
City: Pueblo
State: Colorado
ZIP Code: 81008-2004
Phone: (719) 597-0822

Authorized Official

Name: TANNER HALL
Title: INTERNAL OPERATIONS MANAGER
Phone: (719) 597-0822

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X
Behavior Technician	106S00000X
Occupational Therapy Assistant	224Z00000X
Physical Therapist	225100000X
Physical Therapy Assistant	225200000X
Speech-Language Pathologist	235Z00000X
Occupational Therapist	225X00000X	Primary

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