MEDICARE: DR. JOHN CURTIS DWORS PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	2969	CO

General Provider Information

NPI Number	:	1851457824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN CURTIS DWORS PH.D.

Provider Business Mailing Address
First Line	:	2975 BROADMOOR VALLEY RD
Second Line	:	SUITE 103
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4466
Country	:	US
Telephone Number	:	719-576-1978
Fax Number	:	719-576-1979

Provider Business Practice Location Address
First Line	:	2975 BROADMOOR VALLEY RD
Second Line	:	SUITE 103
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4466
Country	:	US
Telephone Number	:	719-576-1978
Fax Number	:	719-576-1979

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	07/08/2007

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