| Street | 1903 Fayetteville Rd | ||
| City/Town | Van Buren | ||
| State/Province/Region | Arkansas | ||
| Zip/Postal Code | 72956 | ||
| Phone Number | (479) 410-4065 | ||
| Country | United States |
| Full Name | Dr. Derek Sporer PhD | ||
| Gender | male | ||
| Birthday | 1980-06-05 | ||
| Social Security Number | 049-15-6347 |
| Credit card brand | Voyager | ||
| Credit card number | 8699469789809148 | ||
| Expire | 2027/2 | ||
| CVV | 992 |