{
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"ParentOrgLBN": null,
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"OrgName": "TIP TOP SHAPE WELLNESS FITNESS AND PHYSICAL THERAPY FOUNDATION INC",
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"FirstLineMailingAddress": "50 PENNY LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WATSONVILLE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95076-3079",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "888-538-3828",
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"FirstLinePracticeLocationAddress": "50 PENNY LN",
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"PracticeLocationAddressCityName": "WATSONVILLE",
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"PracticeLocationAddressTelephoneNumber": "888-538-3828",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/13/2011",
"LastUpdateDate": "11/13/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VILLAFUERTE",
"AuthorizedOfficialFirstName": "ANNAVAL",
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"AuthorizedOfficialCredential": "PT, GCS, CLT, WCC",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "32295",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}