{
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"OrgName": "PHYSICAL THERAPY FORUM",
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"FirstLineMailingAddress": "5755 NORTHPOINT PARKWAY",
"SecondLineMailingAddress": "SUITE 56",
"MailingAddressCityName": "ALPHARETTA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30022",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "678-462-7456",
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"FirstLinePracticeLocationAddress": "5755 NORTHPOINT PKWY",
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"EnumerationDate": "02/28/2013",
"LastUpdateDate": "02/28/2013",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "GUPTA",
"AuthorizedOfficialFirstName": "AMITA",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "PT",
"AuthorizedOfficialTelephoneNumber": "678-431-1301",
"Taxonomies": {
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"TaxonomyName": "Hearing and Speech Clinic/Center",
"LicenseNumber": "001518",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}