| Street | 8565 N Lilley Rd | ||
| City/Town | Canton | ||
| State/Province/Region | Michigan | ||
| Zip/Postal Code | 48187 | ||
| Phone Number | (888) 767-6424 | ||
| Country | United States |
| Full Name | Dr. Domenico Bradtke Jr. | ||
| Gender | male | ||
| Birthday | 1982-09-14 | ||
| Social Security Number | 101-02-9575 |
| Credit card brand | Unionpay | ||
| Credit card number | 6277480910988218 | ||
| Expire | 2030/5 | ||
| CVV | 289 |