Timely Topics Registration

February 26, 2019
Noon - 1 p.m. Central Time

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* 1. Name:

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* 2. Hospital Name:

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* 3. Tax ID:

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* 4. Payee NPI:

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* 5. Email:

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* 6. Office Phone Number:

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* 7. How many associates will be viewing the Timely Topics with you?

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* 8. Specialty:

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