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"FirstLineMailingAddress": "4849 MACKINAW RD",
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"FirstLinePracticeLocationAddress": "487 N MAIN ST STE D",
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"EnumerationDate": "03/04/2022",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "CLEMENTS",
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"Taxonomies": {
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"TaxonomyName": "Chiropractor",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}