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Ellicott Center For Rehab
200 7th Street • Buffalo, ny 14201-2161
Personal Information
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*
Address
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+ Convenience fee: 3%
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Ellicott Center For Rehab
200 7th Street
Buffalo, ny 14201-2161
Tell: 716-847-2500
[response]
ID #[transid]
[created]
[cardholder]
$ [amount]
[cardtype] [ccnum4]
Authorization Number
[authcode]
AVS Response
[avsresult]
CVV response
[cvcresult]
[otherTransaction]
