{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "P.B.R., INC.",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1310 18TH ST",
"SecondLineMailingAddress": "SUITE B",
"MailingAddressCityName": "SPIRIT LAKE",
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"MailingAddressPostalCode": "51360-1150",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "712-336-0318",
"MailingAddressFaxNumber": "712-336-5742",
"FirstLinePracticeLocationAddress": "1310 18TH ST",
"SecondLinePracticeLocationAddress": "SUITE B",
"PracticeLocationAddressCityName": "SPIRIT LAKE",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "712-336-0318",
"PracticeLocationAddressFaxNumber": "712-336-5742",
"EnumerationDate": "08/22/2006",
"LastUpdateDate": "03/07/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TSCHOPP",
"AuthorizedOfficialFirstName": "WALLY",
"AuthorizedOfficialMiddleName": "J.",
"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "712-728-2165",
"Taxonomies": {
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{
"TaxonomyCode": "3336C0003X",
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"LicenseNumber": "1183",
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"PrimaryTaxonomySwitch": "N"
},
{
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},
{
"TaxonomyCode": "333600000X",
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"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}