{
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"OrgName": "PINNACLE SPORTS & FAMILY WELLNESS",
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"FirstLineMailingAddress": "PO BOX 13142",
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"MailingAddressCityName": "OGDEN",
"MailingAddressStateName": "UT",
"MailingAddressPostalCode": "84412-3142",
"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "365 E LOMOND VIEW DR",
"SecondLinePracticeLocationAddress": "SUITE 201",
"PracticeLocationAddressCityName": "NORTH OGDEN",
"PracticeLocationAddressStateName": "UT",
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"PracticeLocationAddressTelephoneNumber": "385-244-0113",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/01/2012",
"LastUpdateDate": "02/01/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SLEEMAN",
"AuthorizedOfficialFirstName": "MATTHEW",
"AuthorizedOfficialMiddleName": "G.",
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"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "435-225-0992",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "8185843-1202",
"LicenseNumberStateCode": "UT",
"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."
}
}
}
}