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You're suggesting an update to Shady Rest Care Center, Pryor, OK.
What should each field say? Leave a field blank to leave it as it is. Only the fields you change are sent.

Current: SHADY REST CARE CENTER

Current: 210 SOUTH ADAIR

Current: PRYOR

Current: OK

Current: 74361

Current: 9188254455

Current: (none listed)

Current: (none listed)

Current: (none listed)

Current: (none listed)

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