{
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"FirstLineMailingAddress": "2531 E LYON STATION RD",
"SecondLineMailingAddress": "STE F",
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"MailingAddressStateName": "NC",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "2531 E LYON STATION RD",
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"EnumerationDate": "10/15/2014",
"LastUpdateDate": "10/05/2015",
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"NPIReactivationDate": null,
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"Gender": null,
"AuthorizedOfficialLastName": "MEHTA",
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"Taxonomies": {
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"TaxonomyName": "Optometrist",
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}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}