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MemberID
258275
LIC
NULL
HIN
NULL
Address
2147 Southridge Dr
Address2
NULL
City
Tupelo
STATE
MS
AssignmentStatus
NULL
Client
NULL

Affiliate

Territory
NULL
Website
NULL
RegionalSponsor
NULL
XetexCode
IN258275
SystemID
258275
ParentID
NULL
CompanyCode
Intalere

ClassOfTrade

Phone
+1.662.377.6290
Fax
+1.662.377.6295