{
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"FirstLineMailingAddress": "233 S. 123RD DR.",
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"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85323-8043",
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"EnumerationDate": "04/23/2012",
"LastUpdateDate": "04/23/2012",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHATKOWSKI",
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"AuthorizedOfficialTelephoneNumber": "602-819-4951",
"Taxonomies": {
"Taxonomy": {
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"LicenseNumberStateCode": "AZ",
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}
},
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}
}
}
}