{
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"FirstLineMailingAddress": "1421 WESSYNGTON ROAD",
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"MailingAddressStateName": "GA",
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"FirstLinePracticeLocationAddress": "755 MOUNT VERNON HWY.",
"SecondLinePracticeLocationAddress": "SUITE 330",
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"EnumerationDate": "09/05/2017",
"LastUpdateDate": "08/03/2018",
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"AuthorizedOfficialLastName": "ZWALD",
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"TaxonomyName": "Dermatology Physician",
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}
},
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}
}
}
}