{
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"FirstLineMailingAddress": "8059 MITCHELL LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VESTAVIA HILLS",
"MailingAddressStateName": "AL",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "7242 BAILEY COVE RD SE",
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"PracticeLocationAddressCityName": "HUNTSVILLE",
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"EnumerationDate": "04/06/2020",
"LastUpdateDate": "04/13/2020",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SMITH",
"AuthorizedOfficialFirstName": "DONALD",
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"AuthorizedOfficialNameSuffix": "JR.",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Physical Therapist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}