{
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"FirstLineMailingAddress": "4604 COUNTRY GLEN CIR",
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"MailingAddressCityName": "GROVETOWN",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "706-860-7480",
"MailingAddressFaxNumber": "706-860-7458",
"FirstLinePracticeLocationAddress": "4604 COUNTRY GLEN CIR",
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"EnumerationDate": "05/03/2011",
"LastUpdateDate": "05/03/2011",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ROBERTS",
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"AuthorizedOfficialCredential": "RN",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}