C03965;TA103752;TCO3;1;;MARIBEL  PEREZ-468;WILKES-BARRE GWV;1155 EAST MTN. BLVD, ENTRANCE "A" PODIATRY;WILKES BARRE;PA;18711;01/29/25
C03965;TA103752;80011W085;1;;MARIBEL  PEREZ-468;WILKES-BARRE GWV;1155 EAST MTN. BLVD, ENTRANCE "A" PODIATRY;WILKES BARRE;PA;18711;01/29/25
