| Buck Jack Llc | |
|
1301 Fortino Blvd Pueblo CO 81008-2032 | |
| (719) 597-0822 | |
| (719) 599-4606 |
| Full Name | Buck Jack Llc |
|---|---|
| Speciality | Occupational Therapist |
| Location | 1301 Fortino Blvd, Pueblo, Colorado |
| Authorized Official Name and Position | Rebecca Newman (BILLING MANAGER) |
| Authorized Official Contact | 7195970822 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Buck Jack Llc 685 Citadel Dr E Ste 580 Colorado Springs CO 80909-5381 Ph: (719) 597-0822 | Buck Jack Llc 1301 Fortino Blvd Pueblo CO 81008-2032 Ph: (719) 597-0822 |
| NPI Number | 1912505116 |
|---|---|
| Provider Enumeration Date | 10/12/2020 |
| Last Update Date | 10/12/2020 |
| Certification Date | 10/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912505116 | NPI | - | NPPES |
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