{
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"FirstLineMailingAddress": "345 4TH ST NW",
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"FirstLinePracticeLocationAddress": "243 CLARK AVE N",
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"EnumerationDate": "04/04/2012",
"LastUpdateDate": "08/04/2022",
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"NPIDeactivationDate": "05/18/2022",
"NPIReactivationDate": "06/24/2022",
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"AuthorizedOfficialLastName": "MORRISON",
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"Taxonomies": {
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}
},
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}
}
}
}