{
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"FirstLineMailingAddress": "207 CORPORATE DR E",
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"MailingAddressStateName": "PA",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "207 CORPORATE DR E",
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"EnumerationDate": "05/04/2007",
"LastUpdateDate": "04/06/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WAYNE",
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"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialCredential": "AU.D",
"AuthorizedOfficialTelephoneNumber": "215-860-3154",
"Taxonomies": {
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"LicenseNumber": "AT 0005818",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}