{
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"FirstLineMailingAddress": "810 5TH AVE",
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"MailingAddressFaxNumber": "715-623-3333",
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"PracticeLocationAddressFaxNumber": "715-623-3333",
"EnumerationDate": "09/20/2006",
"LastUpdateDate": "07/10/2008",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BARTLETTE",
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"Taxonomies": {
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"TaxonomyName": "Optometrist",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}