{
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"FirstLineMailingAddress": "575 SYLVANWOOD DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TROY",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48085-3125",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "614-893-3437",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "412 N CENTER ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORTHVILLE",
"PracticeLocationAddressStateName": "MI",
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"PracticeLocationAddressTelephoneNumber": "248-348-6166",
"PracticeLocationAddressFaxNumber": "248-348-6711",
"EnumerationDate": "12/12/2013",
"LastUpdateDate": "12/12/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WEHRLE",
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"AuthorizedOfficialMiddleName": "KAY",
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"AuthorizedOfficialCredential": "DC",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Chiropractor",
"LicenseNumber": "2301010131",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}