{
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"FirstLineMailingAddress": "204 VO TECH RD",
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"MailingAddressCityName": "BARTONSVILLE",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "18321-7817",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "INTEGRATIVE HEALTH",
"SecondLinePracticeLocationAddress": "201 LYONS AVE",
"PracticeLocationAddressCityName": "NEWARK",
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"PracticeLocationAddressTelephoneNumber": "201-407-0177",
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"EnumerationDate": "09/01/2020",
"LastUpdateDate": "09/01/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Massage Therapist",
"LicenseNumber": "18KT00374700",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}