Organization

Buck Jack Llc

May also be knows as Woven Care

Speech-Language Pathologist in Colorado Springs, CO(View on Map)

Legal Business Name

Buck Jack Llc

Also Known As

Woven Care

NPI Number

1184237299

NPI Type

Organization

Enumeration Date

08/28/2020

Specialties

(Taxonomies)

Code

235Z00000X
103K00000X
225X00000X
225100000X
103T00000X

Primary Taxonomy

Yes
No
No
No
No

Contact
Information

Purpose

Mailing
Location

Address

2233 ACADEMY PL STE 200
917 E MORENO AVE STE 150

City

Colorado Springs
Colorado Springs

State

CO
CO

Postal Code

80909-1666
80903-4547

Country

US
US

Telephone Number

N/A
(719) 623-6650

Authorized Official

Name

Tanner Denn

Title or Position

CREDENTIALING SPECIALIST

Telephone Number

(719) 428-1840

Identifiers

Identifier

9000185804

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

Provider Address

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