{
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"OrgName": "RAYMOND CHIROPRACTIC, LLC",
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"FirstLineMailingAddress": "1440 S CANFIELD NILES RD STE A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "AUSTINTOWN",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44515-4040",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "330-799-4400",
"MailingAddressFaxNumber": "330-799-4402",
"FirstLinePracticeLocationAddress": "1440 S CANFIELD NILES RD STE A",
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"PracticeLocationAddressCityName": "AUSTINTOWN",
"PracticeLocationAddressStateName": "OH",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "330-799-4400",
"PracticeLocationAddressFaxNumber": "330-799-4402",
"EnumerationDate": "03/04/2008",
"LastUpdateDate": "02/06/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RAYMOND",
"AuthorizedOfficialFirstName": "CHRISTOPHER",
"AuthorizedOfficialMiddleName": "ALAN",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "330-799-4400",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "3890",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}