{
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"FirstLineMailingAddress": "PO BOX 542",
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"FirstLinePracticeLocationAddress": "222 BOWMAN ST",
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"EnumerationDate": "10/11/2006",
"LastUpdateDate": "08/22/2020",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "FOSTER",
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"Taxonomies": {
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"TaxonomyName": "Pain Medicine (Anesthesiology) Physician",
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}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}