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"FirstLinePracticeLocationAddress": "665 DULUTH HWY",
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"EnumerationDate": "02/01/2017",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "OREM",
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"AuthorizedOfficialTelephoneNumber": "678-312-5633",
"Taxonomies": {
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{
"TaxonomyCode": "207Q00000X",
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{
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]
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}