ProviderBusinessMailingAddressFaxNumber = '3374702809'
NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1922206002
MILLER
JO ANNE
IRIS
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE
LA
705086917
1376578963
VINCENT
TRACY
L
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE
LA
705086917
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