Provider Demographics
NPI:1891997888
Name:WORZ, JOHN K (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:K
Last Name:WORZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 KENT RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-6350
Mailing Address - Country:US
Mailing Address - Phone:904-797-2354
Mailing Address - Fax:
Practice Address - Street 1:150 KENT RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-6350
Practice Address - Country:US
Practice Address - Phone:904-797-2354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22105Medicare UPIN