Timely Topics Registration

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* 1. Choose a date and time that works best for you. These are identical sessions.

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* 2. Name:

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* 3. Practice Name:

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* 4. Tax ID:

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* 5. Payee NPI:

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* 6. Email:

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* 7. Office Phone Number:

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

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* 9. Specialty:

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