C03965;TA109392;TCO3;1;1027316;JOSEPH DAVIDSON-301;WILKES-BARRE GWV;1155 EAST MTN. BLVD, ENTRANCE "A" PODIATRY;WILKES BARRE;PA;18711;05/01/25
C03965;TA109392;20220M120;1;1027316;JOSEPH DAVIDSON-301;WILKES-BARRE GWV;1155 EAST MTN. BLVD, ENTRANCE "A" PODIATRY;WILKES BARRE;PA;18711;05/01/25
