Provider Demographics
NPI:1255488755
Name:UNIVERSAL HEALTH AND WELLNESS CENTER, P.C.
Entity Type:Organization
Organization Name:UNIVERSAL HEALTH AND WELLNESS CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:B
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:703-366-3199
Mailing Address - Street 1:7960 DONEGAN DR
Mailing Address - Street 2:STE 233
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-8236
Mailing Address - Country:US
Mailing Address - Phone:703-366-3199
Mailing Address - Fax:703-366-3644
Practice Address - Street 1:7960 DONEGAN DR
Practice Address - Street 2:STE 233
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-8236
Practice Address - Country:US
Practice Address - Phone:703-366-3199
Practice Address - Fax:703-366-3644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA111N00000X
VA2305005258225100000X
VA0104001593261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty