C03965;TA102170;TCO3;1;1027316-CF;CAROL FULMER-894;WILKES-BARRE GWV;1155 EAST MTN. BLVD, ENTRANCE "A" PODIATRY;WILKES BARRE;PA;18711;12/18/24
C03965;TA102170;80053M100;1;1027316-CF;CAROL FULMER-894;WILKES-BARRE GWV;1155 EAST MTN. BLVD, ENTRANCE "A" PODIATRY;WILKES BARRE;PA;18711;12/18/24
