{
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"FirstLineMailingAddress": "15547 N REEMS RD BLDG A",
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"FirstLinePracticeLocationAddress": "15547 N REEMS RD BLDG A",
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"EnumerationDate": "01/04/2017",
"LastUpdateDate": "06/12/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
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"Gender": null,
"AuthorizedOfficialLastName": "LUNDQUIST",
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"Taxonomy": {
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"TaxonomyName": "Ambulatory Surgical Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}