{
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"FirstLineMailingAddress": "415 JEFFERSON ST N",
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"MailingAddressCityName": "WADENA",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "56482-1264",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "218-631-7475",
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"FirstLinePracticeLocationAddress": "415 JEFFERSON ST N",
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"EnumerationDate": "05/14/2007",
"LastUpdateDate": "01/29/2010",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CULLEN",
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"AuthorizedOfficialCredential": "MS, ATC",
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"TaxonomyName": "Critical Access Hospital",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}