{
"Npi": {
"NPI": "1972674653",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MAOZ",
"FirstName": "IVETTE",
"MiddleName": "ANITA",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "LMT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "101 N DEL PUEBLO PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHANDLER",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85226-3679",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "480-940-6438",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5355 W CHANDLER BLVD STE 10",
"SecondLinePracticeLocationAddress": "DRIFTWOOD FAMILY CHIROPRACTIC",
"PracticeLocationAddressCityName": "CHANDLER",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85226-8603",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "480-705-0353",
"PracticeLocationAddressFaxNumber": "480-699-0353",
"EnumerationDate": "11/13/2006",
"LastUpdateDate": "07/08/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "MT-00026P",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}