Practice Information Clause Samples
Practice Information. Any information that the Individual provides to the Consulting Physician or the Practice, during the Consultation or otherwise, will be kept strictly confidential and maintained securely in accordance with applicable federal and state privacy laws.
Practice Information. The individual marital and family therapist who operates this practice is ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇. Her license number is #47375. This practice is a Licensed Marriage and Family Therapist Corporation: THE FAMILY GUIDANCE AND THERAPY
Practice Information. Full legal Practice Name Provider’s Practice Address Provider’s Practice City Provider’s Practice State Provider’s Practice Zip Practice TIN# Preferred Office Phone Preferred Office Fax
Practice Information. Data and/or information relating to your name, contact details (telephone, email, website), ID number, work address, payment information, practice name, and registration number and details under the Health Professions Act No. 56 of 1974 (as amended)