| Name | Description | Type | Additional information |
|---|---|---|---|
| Name | string |
None. |
|
| StreetAddress | string |
None. |
|
| StreetAddress2 | string |
None. |
|
| City | string |
None. |
|
| State | string |
None. |
|
| Zip | string |
None. |
|
| Phone | string |
None. |
|
| Fax | string |
None. |