{
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"MailingAddressCountryCode": "US",
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"PracticeLocationAddressFaxNumber": "270-780-0490",
"EnumerationDate": "06/01/2007",
"LastUpdateDate": "07/27/2017",
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"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
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"TaxonomyName": "Physical Therapist",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}