{
"Npi": {
"NPI": "1467444190",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LUKE PROSTHETIC AND ORTHOTIC LAB, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "117 E WALLACE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FINDLAY",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45840-5219",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "419-422-5009",
"MailingAddressFaxNumber": "419-422-6766",
"FirstLinePracticeLocationAddress": "315 E FOULKE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FINDLAY",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45840-4619",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "740-993-0066",
"PracticeLocationAddressFaxNumber": "419-664-4629",
"EnumerationDate": "08/18/2005",
"LastUpdateDate": "11/22/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LUKE",
"AuthorizedOfficialFirstName": "JEFFREY",
"AuthorizedOfficialMiddleName": "ALAN",
"AuthorizedOfficialTitle": "OWNER, PROSTHETIC",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CPO",
"AuthorizedOfficialTelephoneNumber": "740-993-0066",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": "LP-0069",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}