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"FirstLineMailingAddress": "95 CALICO LN",
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"FirstLinePracticeLocationAddress": "2117 SHORTER AVENUE",
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"EnumerationDate": "08/30/2021",
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"GenderCode": null,
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"AuthorizedOfficialLastName": "HELWIG",
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"Taxonomies": {
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"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}