Provider Demographics
NPI:1962869131
Name:BUCK, WILLIAM (PT, DPT)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:BUCK
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 S GREELEY HWY STE A
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82007-3063
Mailing Address - Country:US
Mailing Address - Phone:970-372-1146
Mailing Address - Fax:970-223-8219
Practice Address - Street 1:9005 GRANT ST STE 200
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4384
Practice Address - Country:US
Practice Address - Phone:303-287-2800
Practice Address - Fax:303-287-7357
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11861225100000X
COPTL.0014643225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist