I hereby authorize my medical records to be released and transferred from:
NORDIN EYE CENTER - 917 BROADWAY ST. PAINTSVILLE, KY 41240 FAX: 606-789-5053
NORDIN EYE CENTER - 929 NORTH LAKE DR. PRESTONSBURG, KY 41653 FAX: 606-886-6628
NORDIN EYE CENTER - 910 MOUNTIAN PARKWAY SLAYERSVILLE, KY 41465 FAX: 606-349-6773
NORDIN EYE CENTER - 100 ALEXANDRIA DR. PIKEVILLE, KY 41501 FAX:
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