Organization
BUCK JACK UTAH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANNER HALL (INTERNAL OPERATIONS MANAGER)
(719) 597-0822
Entity
Organization
Contact information
Practice address
2233 ACADEMY PL STE 201, COLORADO SPRINGS, CO 80909-1679
(719) 597-0822
(719) 599-4606
Mailing address
2233 ACADEMY PL STE 201, COLORADO SPRINGS, CO 80909-1679
(719) 597-0822
(719) 599-4606
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/03/2026
Last updated
02/03/2026
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