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Organization

BUCK JACK LLC

Active
Other names
Woven Care
Organization subpart
No

Provider details

NPI number
Authorized official
TANNER DENN (CREDENTIALING SPECIALIST)
(719) 428-1840
Entity
Organization

Contact information

Practice address
3901 E YALE AVE, DENVER, CO 80210-6646
(719) 597-0822
(719) 599-4606
Mailing address
2233 ACADEMY PL STE 200, COLORADO SPRINGS, CO 80909-1666
(719) 597-0822
(719) 599-4606

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
10/01/2020
Last updated
02/29/2024
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