{
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"FirstLineMailingAddress": "15215 S 48TH ST",
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"MailingAddressCityName": "PHOENIX",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85044-9142",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "480-704-8818",
"MailingAddressFaxNumber": "480-704-8819",
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"PracticeLocationAddressFaxNumber": "480-704-8819",
"EnumerationDate": "05/23/2007",
"LastUpdateDate": "10/08/2007",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KOVAC",
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"AuthorizedOfficialTitle": "DOCTOR OWNER",
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"AuthorizedOfficialCredential": "D.C",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111NR0400X",
"TaxonomyName": "Rehabilitation Chiropractor",
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"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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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."
}
}
}
}