{
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"FirstLineMailingAddress": "673 KINGSLEY AVE STE D",
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"FirstLinePracticeLocationAddress": "673 KINGSLEY AVE STE D",
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"EnumerationDate": "11/30/2021",
"LastUpdateDate": "11/30/2021",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "WIMBERLY",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}