{
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"FirstLineMailingAddress": "635 S STURGEON ST",
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"MailingAddressTelephoneNumber": "573-564-1111",
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"FirstLinePracticeLocationAddress": "635 S STURGEON ST",
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"EnumerationDate": "07/07/2026",
"LastUpdateDate": "07/07/2026",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "MOORE",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}