C04415;TA112863;FOP;1;42304;DESTINEE DOTSON-496;Horton's Orthotic Lab-Jonesboro;2760 Browns Lane Suite A ;Jonesboro;AR;72401;06/30/25
C04415;TA112863;80016W110;1;42304;DESTINEE DOTSON-496;Horton's Orthotic Lab-Jonesboro;2760 Browns Lane Suite A ;Jonesboro;AR;72401;06/30/25
C04415;TA112863;COMP;No
