{
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"FirstLineMailingAddress": "600 HIGHLAND AVE",
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"MailingAddressCityName": "MILFORD",
"MailingAddressStateName": "MI",
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"FirstLinePracticeLocationAddress": "600 HIGHLAND AVE",
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"PracticeLocationAddressTelephoneNumber": "248-714-9925",
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"EnumerationDate": "06/13/2017",
"LastUpdateDate": "07/25/2019",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WILKERSON",
"AuthorizedOfficialFirstName": "MARK",
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"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "810-875-9186",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}