{
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"LastName": null,
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"FirstLineMailingAddress": "880 MARSHALL ST STE A",
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"MailingAddressCityName": "ALLEGAN",
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"MailingAddressPostalCode": "49010-1690",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "269-673-6106",
"MailingAddressFaxNumber": "269-673-1828",
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"PracticeLocationAddressTelephoneNumber": "269-673-6106",
"PracticeLocationAddressFaxNumber": "269-673-1828",
"EnumerationDate": "05/11/2008",
"LastUpdateDate": "08/06/2017",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GIOVANNUCCI",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "269-673-6106",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Chiropractor",
"LicenseNumber": "2301007903",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}