| Document Date: 2013-10-17 17:50:37
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Currency USD / / / IndustryTerm insurance contract / insurance company information / i.e. newspaper / / MedicalCondition N Abnormal bleeding Alcohol/ Drug Abuse Anemia Arthritis/ Stiff / allergies / Fever Blisters High Blood Pressure HIV / Disorder Hepatitis Herpes / Cancer / Valves Asthma Blood Transfusion Cancer / Muscle Disease / AIDS / Arthritis / High Blood Pressure / Heart Disease / Diabetes / disorders / / MedicalTreatment Heart Surgery / Chemotherapy / Radiation / / Organization RESPONSIBLE PARTY / MINOR RESPONSIBLE PARTY / / Person Scarlet Fever Seizures Shingles Sickle / / Position physician / Doctor/ Physician Assistant / REFERRING PHYSICIAN / / ProvinceOrState Maine / Colorado / / Technology SPORTS MEDICINE / Radiation / cellular telephone / Chemotherapy / /
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ALPINE ORTHOPAEDICS & SPORTS MEDICINE, P.C. 112 WEST SPENCER AVENUE 405 ELK AVE