{
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"FirstLineMailingAddress": "980 WESTFALL RD",
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"EnumerationDate": "01/22/2015",
"LastUpdateDate": "06/21/2019",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "MARINO",
"AuthorizedOfficialFirstName": "DANIEL",
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"AuthorizedOfficialCredential": "DC, MS, LAC",
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{
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{
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},
"HealthcareProviderTaxonomyGroups": {
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},
{
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}
]
}
}
}