{
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"FirstLineMailingAddress": "8580 TOWNSHIP ROAD",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "419-422-6200",
"MailingAddressFaxNumber": "419-422-6230",
"FirstLinePracticeLocationAddress": "8580 TOWNSHIP ROAD 237",
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"PracticeLocationAddressFaxNumber": "419-422-6230",
"EnumerationDate": "04/01/2009",
"LastUpdateDate": "04/01/2009",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KELLY",
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"AuthorizedOfficialCredential": "REGISTERED NURSE",
"AuthorizedOfficialTelephoneNumber": "605-226-3300",
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}
},
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}
}