H;C03655;C03655;;20250305;TA105408-03032025GR;;;;;Erie;224 West 26th Street;;Erie;PA;16508;;;03032025GR;003
D;BCO3;;PR;1;William  Clark;
D;647XW120;;PR;1;William  Clark;
H;C03535;C03535;;20250306;TA105670-3/6/25;;;;;Faculty Physicians;1415 Old Weisgarber Road suite 350;;Knoxville;TN;37909;;;3/6/25;003
D;FOP;;PR;1;Brooke Gibson;
H;C03535;C03535;;20250306;TA105671-3/6/25;;;;;Faculty Physicians;1415 Old Weisgarber Road suite 350;;Knoxville;TN;37909;;;3/6/25;003
D;FOP;;PR;1;Keith Waldroop;
H;C01645;C01645;;20250306;TA105673;;;;;Klm Prosthetics;28 Ridge Rd;;Newtown;CT;06470;;;;003
D;FOP;;PR;1;Darnell Smith;
D;80013M095;;PR;1;Darnell Smith;
H;C01270;C01270;;20250306;TA105674;;;;;Foot & Ankle Physicians & Surgeons - Toledo;3055 W Sylvania Ave;;Toledo;OH;43613;;;;003
D;TCO3;;PR;1;Laura Taylor;
D;80019M100;;PR;1;Laura Taylor;