{
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"IsOrgSubpart": "N",
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"OrgName": "SPROUT THERAPY SERVICES",
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"FirstLineMailingAddress": "2083 LAKELYN CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CRESCENT SPRINGS",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "41017-4473",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "859-803-8890",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2083 LAKELYN CT",
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"PracticeLocationAddressCityName": "CRESCENT SPRINGS",
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"PracticeLocationAddressTelephoneNumber": "859-803-8890",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/29/2018",
"LastUpdateDate": "05/29/2018",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RAISPIS",
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"AuthorizedOfficialCredential": "PT",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Early Intervention Provider Agency",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}