C02639;TA113485;TCO1;1;;DONALD 2815-765;Southgate Medical Group, Llc;1026 UNION RD;West Seneca;NY;14224;07/09/25
C02639;TA113485;573W100;1;;DONALD 2815-765;Southgate Medical Group, Llc;1026 UNION RD;West Seneca;NY;14224;07/09/25
C02639;TA113485;COMP;No
