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1515 North Saint Joseph Avenue PO Box 8000 Marsh field, WI 544498000 1.800.472.2363 715.221.9555 TTY: 711 Fax: 715.221.9500Practice Information Request Please attach a copy of your W9. Primary office
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What is practice information request?
Practice information request is a form used to collect information regarding a practice or business.
Who is required to file practice information request?
Any individual or entity who operates a practice or business may be required to file a practice information request.
How to fill out practice information request?
Practice information request can be filled out online or in paper form, providing accurate information about the practice or business.
What is the purpose of practice information request?
The purpose of practice information request is to gather data on practices or businesses for regulatory or statistical analysis.
What information must be reported on practice information request?
Information such as operating hours, services offered, number of employees, revenue, and contact information must be reported on practice information request.
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