Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Buck Jack LLC

Organization Physical Therapist · NPI 1508472317

Buck Jack LLC is a Physical Therapist in Cannon City, Colorado. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Partly verified

Some contact details are missing from the federal record.

Mountain View Core Knowledge School 890 Field Ave
Cannon City, CO 81212-9250
Phone: (719) 597-0822
Fax: (719) 599-4606
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X
Physical Therapist Taxonomy 225100000X
Speech-Language Pathologist Taxonomy 235Z00000X

Record details

NPI number1508472317
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Rebecca Newman — Billing Manager · (719) 597-0822
Other names The Shandy Clinic; The Shandy Clinic
NPI enumeratedSeptember 17, 2020
Last updated in NPPESOctober 1, 2020
Certification dateOctober 1, 2020
Mailing address685 Citadel Dr E Ste 580, Colorado Springs, CO 80909-5381

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