{
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"FirstLineMailingAddress": "30169 JAMESTOWN ST",
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"MailingAddressTelephoneNumber": "734-858-7709",
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"FirstLinePracticeLocationAddress": "4609 S WAYNE RD STE 1",
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"EnumerationDate": "10/21/2019",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PETERSON",
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{
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"PrimaryTaxonomySwitch": "N"
},
{
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}
]
},
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}
}