| Street | 1160 U.S. 46 | ||
| City/Town | Clifton | ||
| State/Province/Region | New Jersey | ||
| Zip/Postal Code | 07013 | ||
| Phone Number | (973) 591-0111 | ||
| Country | United States |
| Full Name | Dr. Juston Rice | ||
| Gender | male | ||
| Birthday | 1978-04-23 | ||
| Social Security Number | 538-71-4497 |
| Credit card brand | Diners Club | ||
| Credit card number | 3011412696531910 | ||
| Expire | 2027/4 | ||
| CVV | 456 |