{
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"FirstLineMailingAddress": "PO BOX 37000",
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"MailingAddressCityName": "BILLINGS",
"MailingAddressStateName": "MT",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "406-656-8818",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3155 AVENUE C",
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"PracticeLocationAddressCityName": "BILLINGS",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/09/2007",
"LastUpdateDate": "01/31/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "QUINONES",
"AuthorizedOfficialFirstName": "KATHLEEN",
"AuthorizedOfficialMiddleName": "ROSSIE",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "406-435-6445",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Physical Therapist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}