{
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"FirstLineMailingAddress": "3401 N BUTLER AVE STE 105",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FARMINGTON",
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"MailingAddressPostalCode": "87401-6867",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "505-787-2184",
"MailingAddressFaxNumber": "505-436-2991",
"FirstLinePracticeLocationAddress": "3401 N BUTLER AVE,",
"SecondLinePracticeLocationAddress": "STE 105",
"PracticeLocationAddressCityName": "FARMINGTON",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "505-787-2184",
"PracticeLocationAddressFaxNumber": "505-436-2991",
"EnumerationDate": "09/14/2019",
"LastUpdateDate": "04/10/2020",
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"NPIReactivationDate": null,
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"Gender": null,
"AuthorizedOfficialLastName": "EBERHART",
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"AuthorizedOfficialCredential": "RRT-SDS, RPSGT",
"AuthorizedOfficialTelephoneNumber": "949-874-5932",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QS1200X",
"TaxonomyName": "Sleep Disorder Diagnostic Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}