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Please fill in your payment details, and simply submit. Payment confirmation email will be send to email account provided in the form below.
Payment functionality (stripe connection) will be possible when account is fully validated, and website is installed under live real domain.
P: 056 7786211E: email@example.comA: City Physiotherapy & Sports Injury ClinicSandy Ridge, Bleach road, Kilkenny. R95 KP83