{
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"FirstLineMailingAddress": "433 ELM STREET",
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"EnumerationDate": "01/30/2007",
"LastUpdateDate": "09/03/2014",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LARSON",
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"AuthorizedOfficialCredential": "MPT",
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{
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},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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},
{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
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}
]
}
}
}