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"FirstLinePracticeLocationAddress": "11515 GAMEL CEMETERY RD",
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"EnumerationDate": "07/08/2019",
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"GenderCode": null,
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"AuthorizedOfficialLastName": "WILLIAMS",
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"AuthorizedOfficialTelephoneNumber": "314-807-9233",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Home Modifications Contractor",
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"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}