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Patient:First Name Last Name Middle Initial Gender:MFP hone # Alt Phone # Practice NPI# Phone () *Fax () E0691E0691E0694DermaPal: Handheld treatment wand for scalp, spot treatment or travel.1 Series:
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Phone alt phone refers to an alternative contact phone number that can be provided when the primary phone number is unavailable or inaccessible.
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The information that must be reported includes the alternate phone number itself and any associated labels to clarify its use (e.g., home, work).
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