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"FirstLineMailingAddress": "1557 BUFORD DR",
"SecondLineMailingAddress": "#491811",
"MailingAddressCityName": "LAWRENCEVILLE",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30049-0185",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1335 HERRINGTON RD",
"SecondLinePracticeLocationAddress": "#2007",
"PracticeLocationAddressCityName": "DULUTH",
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"EnumerationDate": "05/10/2017",
"LastUpdateDate": "05/10/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HACKADAY",
"AuthorizedOfficialFirstName": "KIMBERLY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "LICENSE MASSAGE THERAPIST",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "412-996-0843",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Massage Therapist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}