Secure Membership Checkout
Step 1. Membership Options
Step 2. Member Information
Step 3. Checkout
Step 4. Receipt
Current Total: $
69.00
1-year Medicare Membership
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Billing Information
Email Address:
cliffordguidry@bellsouth.neT
First Name:
Clifford
Last Name:
Guidry
Phone Number:
(337) 893-5829
Address Line 1:
20819 Theall Rd
Address Line 2:
City:
Abbeville
State:
LA
Zip/Postal Code:
70510
Payment Details
Last 4 Digits of Credit Card
XXXX1723
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