NPI 1053919365

Buck Jack LLC

Organisation Occupational Therapist Colorado Springs, CO

Practice location

Address: 6190 Barnes Rd, Colorado Springs, CO 80922-2600
Phone: (719) 597-0822
Fax: (719) 599-4606
Mailing address: 2233 Academy Pl STE 200, Colorado Springs, CO 80909-1666

Authorised official

Name: Tanner Hall
Title: Credentialing Specialist
Phone: (719) 428-1840

Registered specialties (5)

Occupational Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225X00000X

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Behavior Analyst

Behavioral Health & Social Service Providers Taxonomy 103K00000X

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Psychologist

Behavioral Health & Social Service Providers Taxonomy 103T00000X

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Physical Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X

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Speech-Language Pathologist

Speech, Language and Hearing Service Providers Taxonomy 235Z00000X

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Registry record

NPI: 1053919365
Entity type: Organization
NPI issued: 9 Oct 2020
Record last updated: 19 Dec 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.