| Contact Information | |
|---|---|
| First Name | Mack |
| Last Name | Kelly |
| Address | 1150 K St NW |
| Apt #605 | |
| City | Washington |
| State | DC |
| Province | |
| Zip/Postal Code | 20005 |
| Country | United States |
| Home Phone | 202 - 270-5680 |
| mgkelly@gmail.com | |
| Alternate Email | mgkelly@gmail.com |
| Website Address | |
| Gender | Male |
| Injury Information | |
| The injured person is | Self |
| Name of Injured | Mack - Kelly |
| Date of Injury | 12/15/91 |
| Type of Injury | Traumatic |