{
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"FirstLineMailingAddress": "PO BOX 1861",
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"MailingAddressCityName": "IDAHO FALLS",
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"MailingAddressPostalCode": "83403-1861",
"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "208-528-6011",
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"EnumerationDate": "09/30/2006",
"LastUpdateDate": "08/22/2020",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "SOCKETT",
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"Taxonomies": {
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"TaxonomyName": "Chiropractor",
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}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}