{
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"FirstLineMailingAddress": "1801 W 40TH AVE STE 4C",
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"MailingAddressCityName": "PINE BLUFF",
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"MailingAddressPostalCode": "71603-6961",
"MailingAddressCountryCode": "US",
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"EnumerationDate": "05/26/2017",
"LastUpdateDate": "07/21/2022",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "BITZER",
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"AuthorizedOfficialTelephoneNumber": "870-534-6400",
"Taxonomies": {
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}
},
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}
}
}
}