C02639;TA109013;TCO3;1;;THERESA 40617-188;Southgate Medical Group, Llc;1026 UNION RD;West Seneca;NY;14224;04/25/25
C02639;TA109013;843W090;1;;THERESA 40617-188;Southgate Medical Group, Llc;1026 UNION RD;West Seneca;NY;14224;04/25/25
