H;C04415;C04415;;20250324;TA106899;;;;;Horton's Orthotic Lab-Jonesboro;2760 Browns Lane Suite A ;;Jonesboro;AR;72401;;;;003
D;BCO3;;PR;1;DANIEL SPENCER-400;
D;20016M130;;PR;1;DANIEL SPENCER-400;
H;C04415;C04415;;20250324;TA106902;;;;;Klm Prosthetics;28 Ridge Rd;;Newtown;CT;06470;;;;003
D;TCO1;;PR;1;Spencer Tassler;
D;20011M100;;PR;1;Spencer Tassler;
H;C00578;C00578;;20250324;TA106906-0324252;;;;;Chickasaw Nation Shoe Clinic;1904 Carl Albert Blvd, Suite B;;Ada;OK;74820;;;0324252;003
D;20013M130;;PR;1;David Horn;