{
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"FirstLineMailingAddress": "7591 E 9 MILE RD",
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"FirstLinePracticeLocationAddress": "7591 E 9 MILE RD",
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"EnumerationDate": "12/22/2023",
"LastUpdateDate": "12/22/2023",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "KIZY",
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"AuthorizedOfficialCredential": "MANAGER",
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"Taxonomies": {
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{
"TaxonomyCode": "261QD0000X",
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},
{
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}
]
},
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}
}
}
}