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AUTHORIZATION FOR USE AND DISCLOSURE OF HEALTH CARE INFORMATION 5333 McCauley Drive Patients Name Suite 2009 Date of Birth / / Ypsilanti MI, 48197 www.APMandR.com p. 734.712.0050 f. 734.712.0055 Social

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Ypsilanti MI 48197 information typically refers to tax or mailing information for the city of Ypsilanti, MI with zip code 48197.

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