{
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"FirstLineMailingAddress": "1050 15TH ST SW STE 2",
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"MailingAddressCityName": "MASON CITY",
"MailingAddressStateName": "IA",
"MailingAddressPostalCode": "50401-5677",
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"MailingAddressTelephoneNumber": "641-450-0281",
"MailingAddressFaxNumber": "641-450-0284",
"FirstLinePracticeLocationAddress": "1050 15TH ST. S.W.",
"SecondLinePracticeLocationAddress": "SUITE 2",
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"PracticeLocationAddressFaxNumber": "641-450-0284",
"EnumerationDate": "06/18/2017",
"LastUpdateDate": "07/21/2022",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CONNELLY",
"AuthorizedOfficialFirstName": "FRANCIS",
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"AuthorizedOfficialTelephoneNumber": "641-450-0281",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Sleep Medicine (Psychiatry & Neurology) Physician",
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"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}