{
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "231-366-6073",
"FirstLinePracticeLocationAddress": "14 S 3RD AVE",
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"EnumerationDate": "01/20/2021",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KINTIGH",
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"AuthorizedOfficialCredential": "DC",
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"Taxonomies": {
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"TaxonomyName": "Chiropractor",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}