{
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"OrgName": "T&D OPTOMETRY, LLC",
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"FirstLineMailingAddress": "400 SPOTSYLVANIA TOWNE CENTRE",
"SecondLineMailingAddress": "(SPOTSYLVANIA TOWNE CENTRE--NEXT TO JCPENNEY OPTICAL)",
"MailingAddressCityName": "FREDERICKSBURG",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22407",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "400 SPOTSYLVANIA TOWNE CENTRE",
"SecondLinePracticeLocationAddress": "(SPOTSYLVANIA TOWNE CENTRE--NEXT TO JCPENNEY OPTICAL)",
"PracticeLocationAddressCityName": "FREDERICKSBURG",
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"PracticeLocationAddressTelephoneNumber": "571-277-8258",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/04/2016",
"LastUpdateDate": "11/04/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DAMIANI",
"AuthorizedOfficialFirstName": "THOMAS",
"AuthorizedOfficialMiddleName": "NGUYEN",
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"AuthorizedOfficialCredential": "OD",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "0618002402",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}