Buck Jack Llc
May also be knows as The Shandy Clinic
Speech-Language Pathologist in Colorado Springs, CO(View on Map)
Legal Business Name
Buck Jack Llc
Also Known As
The Shandy Clinic
NPI Number
1215548425
NPI Type
Organization
Enumeration Date
08/11/2020
Specialties
(Taxonomies)Name
Code
235Z00000X
103K00000X
225X00000X
225100000X
103T00000X
Primary Taxonomy
Yes
No
No
No
No
Contact
Information
Purpose
Mailing
Location
Address
685 CITADEL DR E STE 580
6190 BARNES RD
City
Colorado Springs
Colorado Springs
State
CO
CO
Postal Code
80909-5381
80922-2600
Country
US
US
Telephone Number
(713) 725-9181
(719) 247-1511
Authorized Official
Name
William Colt
Title or Position
PRESIDENT
Telephone Number
(713) 410-6889
Identifiers
Identifier
9000181601
Identifier State
CO
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 10/01/2020
Provider Address
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