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"FirstLineMailingAddress": "PO BOX 459",
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"FirstLinePracticeLocationAddress": "148 STATE ROUTE 775",
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"PracticeLocationAddressCityName": "PROCTORVILLE",
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"EnumerationDate": "10/11/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BLEVINS",
"AuthorizedOfficialFirstName": "MELANIE",
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"AuthorizedOfficialCredential": "D.D.S.",
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{
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},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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},
{
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}
]
}
}
}