{
"Npi": {
"NPI": "1285512905",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "THE SPINE STUDIO PHYSICAL THERAPY AND WELLNESS, INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "140 N FLORENCE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BURBANK",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91505-3601",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-635-6231",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "140 N FLORENCE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BURBANK",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91505-3601",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-635-6231",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/21/2025",
"LastUpdateDate": "08/21/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AKHBARI",
"AuthorizedOfficialFirstName": "ELENA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPT",
"AuthorizedOfficialTelephoneNumber": "818-635-6231",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}