{
"Npi": {
"NPI": "1366625824",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PERFORMANCE HEALTH & CHIROPRACTIC 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": "1807 S KANNER HWY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "STUART",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34994-7204",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "772-286-6260",
"MailingAddressFaxNumber": "772-286-6912",
"FirstLinePracticeLocationAddress": "1807 S KANNER HWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "STUART",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34994-7204",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "772-286-6260",
"PracticeLocationAddressFaxNumber": "772-286-6912",
"EnumerationDate": "12/07/2007",
"LastUpdateDate": "12/07/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GIAMPIETRO",
"AuthorizedOfficialFirstName": "FRANK",
"AuthorizedOfficialMiddleName": "V.",
"AuthorizedOfficialTitle": "PRRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "772-286-6260",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM1300X",
"TaxonomyName": "Multi-Specialty Clinic/Center",
"LicenseNumber": "CH5633",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}