Provider Demographics
NPI:1124667431
Name:BROTHERS BUCK PC
Entity type:Organization
Organization Name:BROTHERS BUCK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:MORGAN
Authorized Official - Last Name:BUCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-776-6767
Mailing Address - Street 1:600 S AIRPORT RD UNIT CC
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-6407
Mailing Address - Country:US
Mailing Address - Phone:303-776-6767
Mailing Address - Fax:
Practice Address - Street 1:600 S AIRPORT RD UNIT CC
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-6407
Practice Address - Country:US
Practice Address - Phone:303-776-6767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty