{
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"IsOrgSubpart": "N",
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"FirstLineMailingAddress": "2828 10TH AVE S",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GREAT FALLS",
"MailingAddressStateName": "MT",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2828 10TH AVE S",
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"EnumerationDate": "12/21/2020",
"LastUpdateDate": "01/11/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ANDERSON",
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"AuthorizedOfficialTelephoneNumber": "406-868-6899",
"Taxonomies": {
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{
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"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "N"
},
{
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}
]
},
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}
}