C04010;TA110793;80011XW055;1;;Mary Ellen Sylvester;Batavia Foot Care Center;3922 West Main St Rd;Batavia;NY;14020;05/28/25
C04010;TA110793;ORIWXW055;1;;Mary Ellen Sylvester;Batavia Foot Care Center;3922 West Main St Rd;Batavia;NY;14020;05/28/25
C04010;TA110793;COMP;No
