{
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"FirstLineMailingAddress": "PO BOX 2005",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ASHEBORO",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27204-2005",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "336-625-1172",
"MailingAddressFaxNumber": "336-625-6434",
"FirstLinePracticeLocationAddress": "300 MACK RD",
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"PracticeLocationAddressCityName": "ASHEBORO",
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"PracticeLocationAddressTelephoneNumber": "336-625-1172",
"PracticeLocationAddressFaxNumber": "336-625-6434",
"EnumerationDate": "06/21/2006",
"LastUpdateDate": "02/01/2022",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LEWIS",
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"AuthorizedOfficialTelephoneNumber": "336-625-1172",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Primary Care Clinic/Center",
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"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}