{
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"FirstLineMailingAddress": "270 E COURT AVE",
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"FirstLinePracticeLocationAddress": "270 E COURT AVE STE C",
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"PracticeLocationAddressFaxNumber": "731-982-7006",
"EnumerationDate": "07/28/2011",
"LastUpdateDate": "09/23/2015",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MANLEY",
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"Taxonomies": {
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{
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"PrimaryTaxonomySwitch": "N"
},
{
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},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}