Organization
PRIMAL POINT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NGUFOR FUBE DIVINE PMHNP (PRESIDENT)
(410) 870-1590
Entity
Organization
Contact information
Practice address
8713 HARFORD RD STE 102, PARKVILLE, MD 21234-4650
(410) 870-1590
Mailing address
8713 HARFORD RD STE 102, PARKVILLE, MD 21234-4650
(410) 870-1590
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
11/14/2022
Last updated
11/26/2024
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