{
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"FirstLineMailingAddress": "4119 WOODCREST CT",
"SecondLineMailingAddress": null,
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"FirstLinePracticeLocationAddress": "1905 W 32ND ST",
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"EnumerationDate": "02/21/2006",
"LastUpdateDate": "09/17/2007",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "KLONTZ",
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"Taxonomies": {
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"TaxonomyName": "Psychiatry Physician",
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}
},
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}
}
}
}