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Birchwood Terrace Rehab

43 Starr Farm Road • Burlington, VY 05408

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Birchwood Terrace Rehab

43 Starr Farm Road
Burlington, VY 05408

Tell: 802-863-6384

[response]

ID #[transid]

[created]

[cardholder]

[amount]

[cardtype]   [ccnum4]

Authorization Number

[authcode]

AVS Response

[avsresult]

CVV response

[cvcresult]

Thank you for your payment.