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Get Pulmonary Associates Of Southeast Patient Intake Form

50 Gilbreath Drive Oneonta, AL 35121 Sylacauga Clinic Medical Arts Building, Suite 124 120 South Anniston Avenue Sylacauga, AL 35150 Northside Medical Center 70 Plaza Drive Pell City, AL 35125 Chelsea Clinic 16691 Hwy 280 Chelsea, AL 35043 Russell G. Beaty, M.D Sandra K. Gilley, M.D. Allan R. Goldstein, M.D. W. Bishop Kelley, M.D. Karl T. Schroeder, M.D. Alan Q. Thomas, M.D. PATIENT INTAKE FORM Name: Date of birth: Name of Physician that referred you: Briefly de.

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