{
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"FirstLineMailingAddress": "PO BOX 293",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "606-230-2255",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2643 KING KELLY COLEMAN HWY",
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"PracticeLocationAddressCityName": "WAYLAND",
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"EnumerationDate": "02/25/2022",
"LastUpdateDate": "05/26/2022",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "BOW",
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"Taxonomies": {
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}
},
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}
}