{
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"FirstLineMailingAddress": "1101 NW178TH STREET, SUITE A",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "405-285-2600",
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"EnumerationDate": "05/14/2013",
"LastUpdateDate": "01/31/2018",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ABERCROMBIE",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "405-821-8866",
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{
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},
{
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{
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},
{
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},
{
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}
]
},
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}
}