{
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"FirstLineMailingAddress": "89 RANDOLPH ROAD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DRUMMONDS",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "38023",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "901-476-0340",
"MailingAddressFaxNumber": "901-476-0341",
"FirstLinePracticeLocationAddress": "89 RANDOLPH RD",
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"PracticeLocationAddressCityName": "DRUMMONDS",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "38023-6643",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "901-603-8553",
"PracticeLocationAddressFaxNumber": "901-475-1140",
"EnumerationDate": "08/21/2008",
"LastUpdateDate": "02/24/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOWERS",
"AuthorizedOfficialFirstName": "ALECIA",
"AuthorizedOfficialMiddleName": "D",
"AuthorizedOfficialTitle": "OWNER/MEMBER",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "901-476-0340",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Other Technician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}