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811 W. Main Street Suite 207 Lexington SC 29072 Ph 803 358-6420 Fx 803 358-6450 A Lexington Medical Center Physician Practice SandhillsFamilyMedicine. I realize the authorization allows LMC Physician Practices to release any information to any of my insurers or physicians. These services may include pathology radiology emergency services and other special services ordered by my provider. Com Physician Network Authorization/Consent Form GENERAL AUTHORIZATION FOR TREATMENT/CONTACT I authorize...
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