{
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"IsOrgSubpart": "N",
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"OrgName": "TRINITY HEALTH & WELLNESS FAMILY PRACTICE PLLC",
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"NamePrefix": null,
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"FirstLineMailingAddress": "3869 CHESAPEAKE PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAKE HAVASU CITY",
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"MailingAddressPostalCode": "86406-4343",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "603-731-5907",
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"FirstLinePracticeLocationAddress": "45 CAPRI BLVD STE F",
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"PracticeLocationAddressCityName": "LAKE HAVASU CITY",
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"PracticeLocationAddressTelephoneNumber": "928-234-1177",
"PracticeLocationAddressFaxNumber": "928-733-6259",
"EnumerationDate": "10/21/2017",
"LastUpdateDate": "06/16/2018",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DIPAOLA",
"AuthorizedOfficialFirstName": "CHRIS",
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"AuthorizedOfficialCredential": "FNP",
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"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QP2300X",
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},
{
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}
]
},
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}
}