ProviderBusinessMailingAddressFaxNumber = '5736862136'
NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1558361089
TIERRA ALTA ANESTHESIA
209 S MAIN ST
POPLAR BLUFF
MO
639015831
1245227065
MILLER
GARY
A
140 ROSEMONT DR
PADUCAH
KY
420019276
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