{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "JACK FAILLA D.C.P.C.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "30045 HARPER AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAINT CLAIR SHORES",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48082-1649",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "586-772-8560",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "30045 HARPER AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAINT CLAIR SHORES",
"PracticeLocationAddressStateName": "MI",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "586-772-8560",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/09/2009",
"LastUpdateDate": "03/15/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FAILLA",
"AuthorizedOfficialFirstName": "JACK",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C, P.C.",
"AuthorizedOfficialTelephoneNumber": "586-772-8560",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "2301001958",
"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."
}
}
}
}