C03965;TA110296;TCO3;1;1027316-GE;GAIL  EVANS-676;WILKES-BARRE GWV;1155 EAST MTN. BLVD, ENTRANCE "A" PODIATRY;WILKES BARRE;PA;18711;05/16/25
C03965;TA110296;80022W090;1;1027316-GE;GAIL  EVANS-676;WILKES-BARRE GWV;1155 EAST MTN. BLVD, ENTRANCE "A" PODIATRY;WILKES BARRE;PA;18711;05/16/25
