| Street | 11350 Aquila Dr N #101 | ||
| City/Town | Champlin | ||
| State/Province/Region | Minnesota | ||
| Zip/Postal Code | 55316 | ||
| Phone Number | (763) 712-8668 | ||
| Country | United States |
| Full Name | Ms. Marta Konopelski DVM | ||
| Gender | female | ||
| Birthday | 1984-10-28 | ||
| Social Security Number | 429-99-4501 |
| Credit card brand | EnRoute | ||
| Credit card number | 2014007341883564 | ||
| Expire | 2027/8 | ||
| CVV | 178 |