Buck Jack, LLC

NPI #1942002654 in Fountain, Colorado

Provider Information

NPI Number: 1942002654
Entity Type: Organization
Organization Name: Buck Jack, LLC
Primary Specialty: Occupational Therapist
Enumeration Date: Mar 25, 2025
Last Updated: Mar 25, 2025

Practice Location

Address: 6436 S US HIGHWAY 85-87 STE U
City: Fountain
State: Colorado
ZIP Code: 80817-1007
Phone: (719) 597-0822

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapy Assistant	224Z00000X
Physical Therapist	225100000X
Physical Therapy Assistant	225200000X
Speech-Language Pathologist	235Z00000X
Occupational Therapist	225X00000X	Primary

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