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You're suggesting an update to Modoc Medical Center D/P Snf, Alturas, CA.
What should each field say? Leave a field blank to leave it as it is. Only the fields you change are sent.

Current: MODOC MEDICAL CENTER D/P SNF

Current: 228 W MC DOWELL AVE

Current: ALTURAS

Current: CA

Current: 96101

Current: 5302335131

Current: (none listed)

Current: (none listed)

Current: (none listed)

Current: (none listed)

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