{
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"FirstLineMailingAddress": "375 LAKE VIEW DR APT 201",
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"MailingAddressStateName": "MN",
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"FirstLinePracticeLocationAddress": "949 SCHALLER DR S STE 2",
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"EnumerationDate": "09/30/2020",
"LastUpdateDate": "09/30/2020",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "BROWN",
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"AuthorizedOfficialTelephoneNumber": "651-343-9395",
"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}