{
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"NamePrefix": null,
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"FirstLineMailingAddress": "3570 LEXINGTON AVE N",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "651-481-1488",
"MailingAddressFaxNumber": "651-481-8051",
"FirstLinePracticeLocationAddress": "3570 LEXINGTON AVE N",
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"PracticeLocationAddressFaxNumber": "651-481-8051",
"EnumerationDate": "10/07/2010",
"LastUpdateDate": "10/07/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BONSELL",
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"AuthorizedOfficialTelephoneNumber": "651-481-1488",
"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}