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OUTPATIENT PHYSICAL THERAPY
99 DELAWARE AVE. MC182
DELMAR, NY 12054
Phone: (518) 2629700 Fax: (518) 2629720Notice of Advice, Attendance Policy, and Medical Release
Patient Name:
Patient Address:CityStateZipYour
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99 Delaware Ave is a form used to report information about foreign bank accounts held by US taxpayers.
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