{
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"FirstLineMailingAddress": "6852 LIONSHEAD PKWY",
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"MailingAddressStateName": "CO",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "18425 PONY EXPRESS DR",
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"PracticeLocationAddressCityName": "PARKER",
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"PracticeLocationAddressTelephoneNumber": "303-335-0214",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/08/2020",
"LastUpdateDate": "12/08/2020",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RAPHAEL",
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"AuthorizedOfficialCredential": "PT, DPT",
"AuthorizedOfficialTelephoneNumber": "847-644-9668",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Rehabilitation Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}