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Provider Profile Update

This form is for medical providers or their office managers to update their listings in Tanner's Find a Provider database on tanner.org. This form is not for patient appointments. If you need a referral for a physician, please call 770-214-CARE.
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Name
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Email
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Telephone
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Your current practice name:
Your previous practice name (if applicable):
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Provider Name(s):
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Requested Changes:
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Your Title:

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