{
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"FirstLineMailingAddress": "526 HIGHWAY 52 BYP W",
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"MailingAddressFaxNumber": "615-666-2222",
"FirstLinePracticeLocationAddress": "526 HIGHWAY 52 BYP W",
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"EnumerationDate": "11/25/2022",
"LastUpdateDate": "11/29/2023",
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"NPIReactivationDate": null,
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"Gender": null,
"AuthorizedOfficialLastName": "CLENDENIN",
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"AuthorizedOfficialCredential": "PHARM D.",
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"Taxonomy": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}