| Name | Description | Type | Additional information |
|---|---|---|---|
| ProviderID | integer |
None. |
|
| FirstName | string |
None. |
|
| LastName | string |
None. |
|
| DOB | date |
None. |
|
| Gender | string |
None. |
|
| Photo | string |
None. |
|
| Address1 | string |
None. |
|
| Address2 | string |
None. |
|
| City | string |
None. |
|
| State | string |
None. |
|
| ZipCode | string |
None. |
|
| MobilePhone | string |
None. |
|
| ShowPageURL | string |
None. |
|
| ProviderType | string |
None. |