| Contact Information | |
|---|---|
| First Name | Stephen |
| Last Name | Mrachek |
| Address | 5763 NW 71 Terrace |
| City | Parkland |
| State | FL |
| Province | |
| Zip/Postal Code | 33067 |
| Country | United States |
| Home Phone | 954 - 344-0738 |
| Work Phone | 954 - 752-0237 |
| Fax | |
| smrachek@bellsouth.net | |
| Alternate Email | |
| Website Address | |
| Gender | Male |
| Injury Information | |
| The injured person is | Child |
| Name of Injured | Blair - |
| Date of Injury | 12/19/2003 |
| Type of Injury | Traumatic |