{
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"FirstLineMailingAddress": "PO BOX 1766",
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"MailingAddressStateName": "LA",
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"FirstLinePracticeLocationAddress": "101 CIVIC CENTER LN",
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"PracticeLocationAddressCityName": "LAKE HAVASU CITY",
"PracticeLocationAddressStateName": "AZ",
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"PracticeLocationAddressFaxNumber": "928-453-7809",
"EnumerationDate": "08/09/2007",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "DUNN",
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"Taxonomies": {
"Taxonomy": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}
}
}