NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1154627941
FOX
CLEMENT
WADE
5959 S SHERWOOD FOREST BLVD
BATON ROUGE
LA
708166038
1053352328
MARAN
ANTTI
G
411 CALYPSO STREET;
MONROE
LA
71201
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