{
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"OrgName": "WESTERN KANSAS CHIROPRACTIC LLC",
"LastName": null,
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"FirstLineMailingAddress": "920 S MAIN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SCOTT CITY",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "67871-1819",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "920 S MAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SCOTT CITY",
"PracticeLocationAddressStateName": "KS",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "620-872-3004",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/10/2014",
"LastUpdateDate": "12/15/2014",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BABER",
"AuthorizedOfficialFirstName": "BRONSON",
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"AuthorizedOfficialTitle": "MEMBER",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "620-376-8652",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "01-05615",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}