C01111;TA112849;BCO3;1;;Amy Dethample;Family Foot Care;104 Technology Drive Suite 103;Butler;PA;16001;06/30/25
C01111;TA112849;975XW100;1;;Amy Dethample;Family Foot Care;104 Technology Drive Suite 103;Butler;PA;16001;06/30/25
C01111;TA112849;COMP;No
