{
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"EIN": null,
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"ParentOrgLBN": null,
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"LastName": null,
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"NamePrefix": null,
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"OtherLastName": null,
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"FirstLineMailingAddress": "615 W PARK ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LIVINGSTON",
"MailingAddressStateName": "MT",
"MailingAddressPostalCode": "59047-2531",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "406-333-2547",
"MailingAddressFaxNumber": "406-333-2547",
"FirstLinePracticeLocationAddress": "615 W PARK ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LIVINGSTON",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "406-333-2547",
"PracticeLocationAddressFaxNumber": "406-333-2547",
"EnumerationDate": "02/13/2024",
"LastUpdateDate": "09/11/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NEILL",
"AuthorizedOfficialFirstName": "DANNY",
"AuthorizedOfficialMiddleName": "FORREST",
"AuthorizedOfficialTitle": "OWNER / PARTNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "BC-HIS",
"AuthorizedOfficialTelephoneNumber": "406-333-2547",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332S00000X",
"TaxonomyName": "Hearing Aid Equipment",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}