NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
1225274061 |   |   |   | PRIMARY HEALTH & WELLNESS CENTER LLC | 9055 CHEVROLET DR | ELLICOTT CITY | MD | 210424016 |
1073960852 | ASIKE | CHINELO |   |   | 9055 CHEVROLET DR | ELLICOTT CITY | MD | 210424016 |
1396833604 | DAVE | MITUL | N |   | 9055 CHEVROLET DRIVE | ELLICOTT CITY | MD | 21043 |