C00125;TA106046;20018M130;1;;Frank Jedzrowski;Foot Specialist of Long Island;119 New York Ave;Massapequa;NY;11758;06/09/25
C00125;TA106046;TDIMM130;3;;Frank Jedzrowski;Foot Specialist of Long Island;119 New York Ave;Massapequa;NY;11758;06/09/25
C00125;TA106046;COMP;Yes
