{
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"FirstLineMailingAddress": "PO BOX 1475",
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"FirstLinePracticeLocationAddress": "800 E 1ST ST STE 2000",
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"EnumerationDate": "11/14/2007",
"LastUpdateDate": "10/11/2024",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": "12/17/2007",
"NPIReactivationDate": "02/06/2008",
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WHIPPLE",
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"Taxonomies": {
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}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}