{
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"FirstLineMailingAddress": "2600 DODGE ST",
"SecondLineMailingAddress": "STE D4, UNIT 25",
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"FirstLinePracticeLocationAddress": "2600 DODGE ST",
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"EnumerationDate": "05/20/2020",
"LastUpdateDate": "05/20/2020",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CORFMAN",
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"AuthorizedOfficialTelephoneNumber": "563-513-5908",
"Taxonomies": {
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"LicenseNumber": null,
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"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."
}
}
}
}