{
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"FirstLineMailingAddress": "644 HOLLY SPRINGS RD STE 148",
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"MailingAddressStateName": "NC",
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"FirstLinePracticeLocationAddress": "412 FIRE OPAL LANE",
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"PracticeLocationAddressCityName": "HOLLY SPRINGS",
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"EnumerationDate": "05/06/2022",
"LastUpdateDate": "07/21/2022",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "JOHNSON",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Physical Rehabilitation Occupational Therapist",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}