{
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"FirstLineMailingAddress": "PO BOX 2018",
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"FirstLinePracticeLocationAddress": "13800 US ROUTE 23 NORTH",
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"PracticeLocationAddressFaxNumber": "740-947-7943",
"EnumerationDate": "11/08/2006",
"LastUpdateDate": "01/14/2010",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MADSEN",
"AuthorizedOfficialFirstName": "DANIEL",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}