H;C04010;C04010;;20241203;TA101367;;;;;Batavia Foot Care Center;3922 West Main St Rd;;Batavia;NY;14020;;;
D;80013XW050;;PR;1;Shirley Tracy;
D;80013XW055;;PR;1;Shirley Tracy;
D;TDIWXW055;;PR;3;Shirley Tracy;