{
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"FirstLineMailingAddress": "11 S MILL ST STE 200",
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"FirstLinePracticeLocationAddress": "100 STADIUM DR STE A",
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"PracticeLocationAddressCityName": "DEFIANCE",
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"EnumerationDate": "06/23/2017",
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"GenderCode": null,
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"AuthorizedOfficialLastName": "MATTA",
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"Taxonomies": {
"Taxonomy": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}