C03965;TA105090;TCO3;1;1027316-MV;MELISSA VITAL-924;WILKES-BARRE GWV;1155 EAST MTN. BLVD, ENTRANCE "A" PODIATRY;WILKES BARRE;PA;18711;02/25/25
C03965;TA105090;80021W055;1;1027316-MV;MELISSA VITAL-924;WILKES-BARRE GWV;1155 EAST MTN. BLVD, ENTRANCE "A" PODIATRY;WILKES BARRE;PA;18711;02/25/25
