{
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"OrgName": "CORE HEALTH",
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"FirstLineMailingAddress": "19309 WINMEADE DR",
"SecondLineMailingAddress": "NUMBER 111",
"MailingAddressCityName": "LANSDOWNE",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "20176-6507",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "703-283-3311",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "20098 ASHBROOK PL",
"SecondLinePracticeLocationAddress": "SUITE 190",
"PracticeLocationAddressCityName": "ASHBURN",
"PracticeLocationAddressStateName": "VA",
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"PracticeLocationAddressCountryCode": "US",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/17/2008",
"LastUpdateDate": "06/17/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SMALL",
"AuthorizedOfficialFirstName": "JENNIFER",
"AuthorizedOfficialMiddleName": "WOODARD",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "D.P.T.",
"AuthorizedOfficialTelephoneNumber": "703-283-3311",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}