C00168;TA113703;TCO3;1;;Ida Lopez;Alliance Prosthetics and Orthotics;12458 Washington Blvd;Whittier;CA;90602;07/14/25
C00168;TA113703;80061W100;1;;Ida Lopez;Alliance Prosthetics and Orthotics;12458 Washington Blvd;Whittier;CA;90602;07/14/25
C00168;TA113703;COMP;No
