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MemberID
NULL
LIC
XYAG
HIN
NULL
Address
3351 N Downer Ave
Address2
City
Milwaukee
STATE
WI
ZIP
53211.00
AssignmentStatus
Tentative
Client
UHC
Territory
NULL
XetexCode
NOVXYAG
SystemID
40357
ParentID
40357
CompanyCode
Novation
Phone
(414) 229-6580