Organization

Buck Jack Llc

May also be knows as Woven Care

Occupational Therapist in Colorado Springs, CO(View on Map)

Legal Business Name

Buck Jack Llc

Also Known As

Woven Care

NPI Number

1104424423

NPI Type

Organization

Enumeration Date

10/09/2020

Specialties

(Taxonomies)

Code

225X00000X
103K00000X
225100000X
103T00000X
235Z00000X

Primary Taxonomy

Yes
No
No
No
No

Contact
Information

Purpose

Mailing
Location

Address

2233 ACADEMY PL STE 200
3625 CITADEL DR S

City

Colorado Springs
Colorado Springs

State

CO
CO

Postal Code

80909-1666
80909-5320

Country

US
US

Telephone Number

(719) 597-0822
(719) 597-0822

Authorized Official

Name

Tanner Denn

Title or Position

CREDENTIALING SPECIALIST

Telephone Number

(719) 428-1840

Identifiers

Identifier

9000190917

Identifier State

CO

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/28/2024

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