{
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"FirstLineMailingAddress": "73 BARRENS CHURCH RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DILLSBURG",
"MailingAddressStateName": "PA",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "717-576-5450",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "73 BARRENS CHURCH RD",
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"PracticeLocationAddressCityName": "DILLSBURG",
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"EnumerationDate": "06/02/2020",
"LastUpdateDate": "07/02/2020",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COULON",
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"AuthorizedOfficialCredential": "PT, DPT, ATP",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Physical Therapy Clinic/Center",
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"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}