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PERRY MANSFIELD M.D. INC REGISTRATION FORM (Please Print) Today's date:Primary Care Provider:PATIENT INFORMATION Patients last name:First:Is this your legal name? Middle:If not, what is your legal
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Perry Mansfield M is a form used to report certain financial information to the IRS.
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The purpose of Perry Mansfield M is to report financial information to the IRS for tax compliance and regulatory purposes.
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