ProviderBusinessMailingAddressFaxNumber = '9317663339'

NPI	LastName	FirstName	MidName	Organization	Mailing Address	City	State	Zip
1215144936				AMG-CROCKETT, LLC	PO BOX 847	LAWRENCEBURG	TN	384640847
1689843153				AMG-CROCKETT, LLC	PO BOX 847	LAWRENCEBURG	TN	384640847

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