{
"Npi": {
"NPI": "1831355601",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ARCHER PHYSICAL THERAPY, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 2031",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FORT OGLETHORPE",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30742-0031",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "423-693-5490",
"MailingAddressFaxNumber": "678-349-0693",
"FirstLinePracticeLocationAddress": "3012 LAFAYETTE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FORT OGLETHORPE",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30742-3782",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "423-693-5490",
"PracticeLocationAddressFaxNumber": "678-349-0693",
"EnumerationDate": "07/31/2008",
"LastUpdateDate": "08/24/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARTIN",
"AuthorizedOfficialFirstName": "DEBRA",
"AuthorizedOfficialMiddleName": "ELIZABETH",
"AuthorizedOfficialTitle": "OWNER/PHYSICAL THERAPIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.S.P.T., MLD/CDT",
"AuthorizedOfficialTelephoneNumber": "423-693-5490",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "PT004654",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}