C04306;TA111588;BCO3;1;;324543JMO -118;Advanced Regional Ctr for Orthopedics & Podiatry;711 Logan Blvd;Altoona;PA;16602;06/09/25
C04306;TA111588;20018M100;1;;324543JMO -118;Advanced Regional Ctr for Orthopedics & Podiatry;711 Logan Blvd;Altoona;PA;16602;06/09/25
C04306;TA111588;COMP;No
