{
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "FOUR TOWERS INVESTMENT INC.",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "35445 23 MILE RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEW BALTIMORE",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48047-3601",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "586-716-9101",
"MailingAddressFaxNumber": "586-716-9104",
"FirstLinePracticeLocationAddress": "35445 23 MILE RD",
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"PracticeLocationAddressCityName": "NEW BALTIMORE",
"PracticeLocationAddressStateName": "MI",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "586-716-9101",
"PracticeLocationAddressFaxNumber": "586-716-9104",
"EnumerationDate": "03/19/2008",
"LastUpdateDate": "01/19/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WOYTTA",
"AuthorizedOfficialFirstName": "THOMAS",
"AuthorizedOfficialMiddleName": "OWEN",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D",
"AuthorizedOfficialTelephoneNumber": "810-364-1334",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "4901002400",
"LicenseNumberStateCode": "MI",
"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."
}
}
}
}