{
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"FirstLineMailingAddress": "1676 MAIN ST",
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"FirstLinePracticeLocationAddress": "1676 MAIN ST",
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"EnumerationDate": "02/02/2016",
"LastUpdateDate": "02/02/2016",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "LEE",
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"AuthorizedOfficialTelephoneNumber": "920-327-1565",
"Taxonomies": {
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"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}