{
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"FirstLineMailingAddress": "4245 W JOLLY RD LOT 120",
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"MailingAddressTelephoneNumber": "517-219-6348",
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"FirstLinePracticeLocationAddress": "4245 W JOLLY RD LOT 120",
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"EnumerationDate": "09/02/2025",
"LastUpdateDate": "09/02/2025",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCCOY",
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"AuthorizedOfficialCredential": "NURSE ASSISTANT",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}