| Street | 316 N Main St | ||
| City/Town | West Hartford | ||
| State/Province/Region | Connecticut | ||
| Zip/Postal Code | 06117 | ||
| Phone Number | (860) 231-8166 | ||
| Country | United States |
| Full Name | Dr. Osborne Sipes | ||
| Gender | male | ||
| Birthday | 1996-01-27 | ||
| Social Security Number | 317-35-4856 |
| Credit card brand | JCB | ||
| Credit card number | 3506217653638539 | ||
| Expire | 2029/9 | ||
| CVV | 461 |