{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "HEALTHY SPINES CHIROPRACTIC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1473 N DYSART RD",
"SecondLineMailingAddress": "SUITE 101",
"MailingAddressCityName": "AVONDALE",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85323-1548",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "623-925-1386",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1473 N DYSART RD",
"SecondLinePracticeLocationAddress": "SUITE 101",
"PracticeLocationAddressCityName": "AVONDALE",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85323-1548",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "623-925-1386",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/26/2015",
"LastUpdateDate": "05/13/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STEWART",
"AuthorizedOfficialFirstName": "HEATHER",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DOCTOR OF CHIROPRACTIC",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "623-925-1386",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "8386",
"LicenseNumberStateCode": "AZ",
"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."
}
}
}
}