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HME215921 W. Front St. Traverse City, Mi 496842319352100 Phone 2319350845 FaxMunson Home Medical Equipment Standard Written Order Oxygenation Name or Label ___ DOB___ Emergency Contact Name:___Phone:

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Patients who require oxygen therapy for medical conditions such as COPD, asthma, or other respiratory problems.

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Healthcare facilities that provide care for patients in need of oxygen supplementation.

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