C00125;TA102904;510XW095;1;;WILLIAM JOHNSEN;Foot Specialist of Long Island;119 New York Ave;Massapequa;NY;11758;01/10/25
C00125;TA102904;TDIMXW095;3;;WILLIAM JOHNSEN;Foot Specialist of Long Island;119 New York Ave;Massapequa;NY;11758;01/10/25
