Provider Demographics
NPI:1649448564
Name:UNIVERSAL CARE CLINICS, INC.
Entity type:Organization
Organization Name:UNIVERSAL CARE CLINICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATEUS
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRAZ-SOUZA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-222-1155
Mailing Address - Street 1:220 ROBERT ST S STE 104
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55107-1626
Mailing Address - Country:US
Mailing Address - Phone:651-222-1155
Mailing Address - Fax:
Practice Address - Street 1:220 ROBERT ST S STE 104
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55107-1626
Practice Address - Country:US
Practice Address - Phone:651-222-1155
Practice Address - Fax:651-222-1188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4992111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty