{
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"FirstLineMailingAddress": "65 S SQUIRREL RD",
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"MailingAddressCityName": "AUBURN HILLS",
"MailingAddressStateName": "MI",
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"FirstLinePracticeLocationAddress": "65 S SQUIRREL RD",
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"EnumerationDate": "03/12/2022",
"LastUpdateDate": "09/15/2023",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VEZINA",
"AuthorizedOfficialFirstName": "KATHERINE",
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"AuthorizedOfficialCredential": "DPT",
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"Taxonomy": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}