{
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"OrgName": "ELITE CHIROPRACTIC & WELLNESS OF BAY COUNTY INC",
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"FirstLineMailingAddress": "1705 RHODE ISLAND AVE",
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"MailingAddressCityName": "LYNN HAVEN",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32444-4161",
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"FirstLinePracticeLocationAddress": "2410 LISENBY AVE",
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"PracticeLocationAddressCityName": "PANAMA CITY",
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"PracticeLocationAddressTelephoneNumber": "850-704-0008",
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"EnumerationDate": "10/30/2017",
"LastUpdateDate": "10/30/2017",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BELL",
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"AuthorizedOfficialMiddleName": "LEIGH",
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialCredential": "DC",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Chiropractor",
"LicenseNumber": "CH10576",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}