C03965;TA102766;TCO3;1;1027316-KS;KEVEN SPENCER-169;WILKES-BARRE GWV;1155 EAST MTN. BLVD, ENTRANCE "A" PODIATRY;WILKES BARRE;PA;18711;01/07/25
C03965;TA102766;40031M120;1;1027316-KS;KEVEN SPENCER-169;WILKES-BARRE GWV;1155 EAST MTN. BLVD, ENTRANCE "A" PODIATRY;WILKES BARRE;PA;18711;01/07/25
