C04415;TA112864;TCO3;1;42319;JERRY MCKINNEY-497;Horton's Orthotic Lab-Jonesboro;2760 Browns Lane Suite A ;Jonesboro;AR;72401;06/30/25
C04415;TA112864;40031XW110;1;42319;JERRY MCKINNEY-497;Horton's Orthotic Lab-Jonesboro;2760 Browns Lane Suite A ;Jonesboro;AR;72401;06/30/25
C04415;TA112864;COMP;No
