H;C03249;C03249;;20250117;TA103212-8704;;;;;North Carolina Orthotics And Pros.;1306 Wayne Memorial Drive Ste C;;Goldsboro;NC;27534;;;8704
D;PPFR;;PR;1;CARMEN GONZALEZ RAMOS;
D;897M090;;PR;1;CARMEN GONZALEZ RAMOS;
H;C03535;C03535;;20250117;TA103213-1/17/25;;;;;Faculty Physicians;1415 Old Weisgarber Road suite 350;;Knoxville;TN;37909;;;1/17/25
D;92003XW100;;PR;1;Jacqueline Davidson;
D;TDIWXW100;;PR;3;Jacqueline Davidson;