ProviderBusinessMailingAddressFaxNumber = '9035415393'

NPI	LastName	FirstName	MidName	Organization	Mailing Address	City	State	Zip
1922599422	HENDRICKSON	TODD	STEPHEN		203 NACOGDOCHES ST STE 280	JACKSONVILLE	TX	757662444
1801002837	MCINNIS	JUSTIN	M		203 NACOGDOCHES ST STE 280	JACKSONVILLE	TX	757662444

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