{
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"FirstLineMailingAddress": "19 BELMONT AVE",
"SecondLineMailingAddress": "SUITE 104",
"MailingAddressCityName": "BRATTLEBORO",
"MailingAddressStateName": "VT",
"MailingAddressPostalCode": "05301-7109",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "802-258-6590",
"MailingAddressFaxNumber": "802-258-6525",
"FirstLinePracticeLocationAddress": "19 BELMONT AVE",
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"EnumerationDate": "12/14/2010",
"LastUpdateDate": "12/14/2010",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "DONALDSON",
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"AuthorizedOfficialCredential": "M.D., PHD",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Neurology Physician",
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"LicenseNumberStateCode": "VT",
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}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}