| Name | Description | Type | Additional information |
|---|---|---|---|
| Street1 | string |
None. |
|
| Street2 | string |
None. |
|
| City | string |
None. |
|
| State | string |
None. |
|
| Zip | string |
None. |
|
| Country | string |
None. |
|
| Phone |
Practice Office Phone or Clinician Mobile Phone |
string |
None. |
| Fax | string |
None. |
|
| string |
None. |
||
| URL | string |
None. |
|
| SMS | string |
None. |
|
| Other | string |
None. |