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
1321 S PRAIRIE AVE, PUEBLO, CO 81005-2307
(719) 569-4411
Mailing address
685 CITADEL DR E STE 580, COLORADO SPRINGS, CO 80909-5381
(713) 725-9181
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000191408
—
CO
Enumeration date
08/28/2020
Last updated
02/28/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us