Buck Jack, LLC
Occupational Therapist in Denver, CO. Organization (NPI-2).
NPI number1124872809
StatusActive
Last updated in NPPESApr 17, 2024
Details
- NPI
- 1124872809
- Entity type
- Organization (NPI-2)
- Legal business name
- Buck Jack, LLC
- Organization subpart
- No
- Enumeration date
- Apr 17, 2024
- Certification date
- Apr 17, 2024
- Last updated
- Apr 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | – | – | Yes |
| 103K00000X | Behavior Analyst | – | – | |
| 106S00000X | Behavior Technician | – | – | |
| 225100000X | Physical Therapist | – | – | |
| 235Z00000X | Speech-Language Pathologist, | – | – |
Practice location
3901 E Yale AveDenver, CO 80210-6646
Phone 719-597-0822
Mailing address
2233 Academy Pl Ste 200Colorado Springs, CO 80909-1666
Phone 719-597-0822
Authorized official
Tanner Hall
Credentialing Specialist
7194281840
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