{
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"FirstLineMailingAddress": "POST OFFICE BOX 803",
"SecondLineMailingAddress": "1195 HISEY AVENUE",
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"MailingAddressStateName": "VA",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "540-459-7772",
"MailingAddressFaxNumber": "540-459-7782",
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"PracticeLocationAddressFaxNumber": "540-459-7782",
"EnumerationDate": "10/25/2006",
"LastUpdateDate": "07/12/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "REICHLEY",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "J",
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"AuthorizedOfficialCredential": "MPT",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Physical Therapist",
"LicenseNumber": "0105005306",
"LicenseNumberStateCode": "VA",
"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."
}
}
}
}