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"FirstLineMailingAddress": "5570 WILSON AVE SW",
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"EnumerationDate": "10/14/2015",
"LastUpdateDate": "10/14/2015",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "KONYNENBELT",
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"AuthorizedOfficialCredential": "D.C., M.S.",
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}
]
},
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},
{
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}
]
}
}
}