ProviderBusinessMailingAddressFaxNumber = '5186420693'
NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1487645826
GREGORY
ANN
MARIE
PO BOX 304
GLENS FALLS
NY
128010304
1306974845
SHORT
CYNTHIA
LARRABEE
79 NORTH ST
GRANVILLE
NY
128321137
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