{
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"FirstLineMailingAddress": "867 E HIGH ST",
"SecondLineMailingAddress": "SUITE 230",
"MailingAddressCityName": "LEXINGTON",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "40502-2156",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "859-268-7501",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "867 E HIGH ST",
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"EnumerationDate": "02/06/2009",
"LastUpdateDate": "02/06/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VAN ROOY",
"AuthorizedOfficialFirstName": "BETHANY",
"AuthorizedOfficialMiddleName": "LEE",
"AuthorizedOfficialTitle": "CHIROPRACTOR/OWNER",
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"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "859-268-7501",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "111NS0005X",
"TaxonomyName": "Sports Physician Chiropractor",
"LicenseNumber": "5038",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "111NN1001X",
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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{
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},
{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
]
}
}
}