{
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "REUNION PHYSICAL THERAPY PS",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1802 S UNION AVENUE",
"SecondLineMailingAddress": "#100",
"MailingAddressCityName": "TACOMA",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98405-1947",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "253-756-8668",
"MailingAddressFaxNumber": "253-759-5138",
"FirstLinePracticeLocationAddress": "1802 S UNION AVENUE",
"SecondLinePracticeLocationAddress": "#100",
"PracticeLocationAddressCityName": "TACOMA",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98405-1947",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "253-756-8668",
"PracticeLocationAddressFaxNumber": "253-759-5138",
"EnumerationDate": "10/18/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BROWN",
"AuthorizedOfficialFirstName": "ROBERT",
"AuthorizedOfficialMiddleName": "NIEL",
"AuthorizedOfficialTitle": "OWNER PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHYSICAL THERAPIST",
"AuthorizedOfficialTelephoneNumber": "253-756-8668",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "PT00003144",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}