{
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"FirstLineMailingAddress": "55 S VAIL AVE APT 1214",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ARLINGTON HEIGHTS",
"MailingAddressStateName": "IL",
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"FirstLinePracticeLocationAddress": "7161 W Q AVE",
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"PracticeLocationAddressCityName": "KALAMAZOO",
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"EnumerationDate": "08/16/2017",
"LastUpdateDate": "08/16/2017",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COPELAND",
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"AuthorizedOfficialCredential": "OD",
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"TaxonomyName": "Optometrist",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}