C03965;TA103923;TCO3;1;1027316-AJ;ALVIN JOHNSON-515;WILKES-BARRE GWV;1155 EAST MTN. BLVD, ENTRANCE "A" PODIATRY;WILKES BARRE;PA;18711;01/31/25
C03965;TA103923;20219M105;1;1027316-AJ;ALVIN JOHNSON-515;WILKES-BARRE GWV;1155 EAST MTN. BLVD, ENTRANCE "A" PODIATRY;WILKES BARRE;PA;18711;01/31/25
