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"FirstLineMailingAddress": "PO BOX 693",
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"MailingAddressFaxNumber": "405-925-2106",
"FirstLinePracticeLocationAddress": "1800 RENAISSANCE BLVD STE 250",
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"PracticeLocationAddressCityName": "EDMOND",
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"EnumerationDate": "01/09/2023",
"LastUpdateDate": "05/23/2023",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "RENSHAW",
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"AuthorizedOfficialCredential": "MPT",
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"Taxonomy": [
{
"TaxonomyCode": "261QP2000X",
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},
{
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}
]
},
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}
}
}
}