{
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"FirstLineMailingAddress": "3412 N 24TH ST",
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"MailingAddressStateName": "WI",
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"FirstLinePracticeLocationAddress": "3412 N 24TH ST",
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"EnumerationDate": "01/17/2018",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GRIFFIN",
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"Taxonomy": {
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"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}