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MemberID
397257
LIC
NULL
HIN
NULL
Address
1821 Academy Rd
Address2
NULL
City
Grand Coteau
STATE
LA
AssignmentStatus
NULL
Client
NULL

Affiliate

Territory
NULL
Website
NULL
RegionalSponsor
NULL
XetexCode
IN397257
SystemID
397257
ParentID
NULL
CompanyCode
Intalere
Phone
+1.337.662.5275
Fax
+1.337.662.3011