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Integrative Family Medicine
7468 N. LA COLLAR BLVD., TUCSON, AZ 85741
PHONE (520) 2979664 FAX (520) 2979633
PATIENTS LEGAL NAMED ATE OF AIRMAILING ADDRESSMARRIED
MALECITYSTATESTATESINGLE
FEMALE
EMPLOYERZIPRESIDENCE
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Complete MMC forms refer to the forms that include all the necessary information and data required by the regulatory authorities.
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Any entity or individual that is subject to regulatory reporting requirements is required to file complete MMC forms.
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