{
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"FirstLineMailingAddress": "1607 E US HIGHWAY 136",
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"EnumerationDate": "08/27/2007",
"LastUpdateDate": "09/16/2024",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CARVELL",
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"AuthorizedOfficialTelephoneNumber": "816-273-0437",
"Taxonomies": {
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}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}