| Street | 121 N 4th St | ||
| City/Town | Bismarck | ||
| State/Province/Region | North Dakota | ||
| Zip/Postal Code | 58501 | ||
| Phone Number | (701) 223-3770 | ||
| Country | United States |
| Full Name | Dr. Ambrose Greenfelder | ||
| Gender | male | ||
| Birthday | 1993-05-30 | ||
| Social Security Number | 577-53-6899 |
| Credit card brand | Voyager | ||
| Credit card number | 8699120429239515 | ||
| Expire | 2027/3 | ||
| CVV | 192 |