C01630;TA113095;672W085;1;;Walter Blakely;Kevin Powers, Dpm;1791 W Third Street;Bloomington;IN;47404;07/02/25
C01630;TA113095;TDIMW085;3;;Walter Blakely;Kevin Powers, Dpm;1791 W Third Street;Bloomington;IN;47404;07/02/25
C01630;TA113095;COMP;No
