{
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"FirstLineMailingAddress": "PO BOX 1430",
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"EnumerationDate": "11/08/2006",
"LastUpdateDate": "06/24/2014",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "FOSTER",
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}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}