{
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"FirstLineMailingAddress": "57 S MAIN ST",
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"MailingAddressCityName": "MONROE",
"MailingAddressStateName": "UT",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "57 S MAIN ST",
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"PracticeLocationAddressCityName": "MONROE",
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"EnumerationDate": "01/27/2015",
"LastUpdateDate": "04/27/2015",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DASTRUP",
"AuthorizedOfficialFirstName": "DANIEL",
"AuthorizedOfficialMiddleName": "JOSEPH",
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"Taxonomies": {
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"TaxonomyName": "Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}