{
"Npi": {
"NPI": "1710336995",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MASSAGE MATTERS MICHIGAN LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "13960 METTETAL ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DETROIT",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48227-1747",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "313-586-2026",
"MailingAddressFaxNumber": "866-466-3087",
"FirstLinePracticeLocationAddress": "21331 KELLY RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EASTPOINTE",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48021-3265",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "313-293-9427",
"PracticeLocationAddressFaxNumber": "866-466-3087",
"EnumerationDate": "06/08/2016",
"LastUpdateDate": "06/08/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BUFORD",
"AuthorizedOfficialFirstName": "SHERITTA",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "LICENSED MASSAGE THERAPIST",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "L.M.T",
"AuthorizedOfficialTelephoneNumber": "313-293-1054",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251K00000X",
"TaxonomyName": "Public Health or Welfare Agency",
"LicenseNumber": "7501009330",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}