| Street | 6000 S Cherokee St | ||
| City/Town | Muskogee | ||
| State/Province/Region | Oklahoma | ||
| Zip/Postal Code | 74403 | ||
| Phone Number | (918) 683-5181 | ||
| Country | United States |
| Full Name | Dr. Lavonne Crist Jr. | ||
| Gender | female | ||
| Birthday | 1978-02-20 | ||
| Social Security Number | 137-25-9296 |
| Credit card brand | Discover | ||
| Credit card number | 6011415706232380 | ||
| Expire | 2028/2 | ||
| CVV | 224 |