{
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"FirstLineMailingAddress": "1925 S GLENSTONE AVE",
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"MailingAddressStateName": "MO",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "417-881-2910",
"MailingAddressFaxNumber": "417-890-1579",
"FirstLinePracticeLocationAddress": "3050 S NATIONAL AVE, STE 109",
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"PracticeLocationAddressTelephoneNumber": "417-881-2910",
"PracticeLocationAddressFaxNumber": "417-881-3014",
"EnumerationDate": "10/20/2006",
"LastUpdateDate": "09/02/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GROVE",
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"AuthorizedOfficialTelephoneNumber": "417-881-2910",
"Taxonomies": {
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{
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"PrimaryTaxonomySwitch": "N"
},
{
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}
]
},
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}
}