{
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"FirstLineMailingAddress": "5764 RAMSDELL DR NE",
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"MailingAddressCityName": "ROCKFORD",
"MailingAddressStateName": "MI",
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"FirstLinePracticeLocationAddress": "515 E DIVISION ST",
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"PracticeLocationAddressCityName": "ROCKFORD",
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"EnumerationDate": "03/07/2018",
"LastUpdateDate": "06/16/2018",
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"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Orthopedic Physical Therapist",
"LicenseNumber": "5501010516",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}