{
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"OrgName": "ULTIMATE PERFORMANCE THERAPY, LLC",
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"FirstLineMailingAddress": "403 VENTURE CT, SUITE 2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VERONA",
"MailingAddressStateName": "WI",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "608-338-0525",
"FirstLinePracticeLocationAddress": "403 VENTURE CT, SUITE 2",
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"EnumerationDate": "02/01/2012",
"LastUpdateDate": "02/01/2012",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "RUPNOW",
"AuthorizedOfficialFirstName": "BRADLEY",
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"AuthorizedOfficialCredential": "PT, DPT, LAT",
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"Taxonomy": {
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"TaxonomyName": "Physical Therapist",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}
}
}