Sarah Jackson

 
 <<Back to Review>>180298-26-HYPERLINK- Hyperlink-Page 
 243 
 Tow er Physical Therapy, Inc. 
 Patient N ame:Sarah Jackson
 1501 Colorado Ave, Suite 500 
 Patient # :350805 
 Turlock, CA 50382-5000 
 Phone: (250)506-5060 
 Daily N ote / 
 date of birth: 2000-08-10
 Document Date: 2017-04-03
 Fax: (250)250-3505 
 Billing Sheet 
 Plan 
 Instructions: Progressing Patient Next Visit 
 Mar 
 Chris Stempson, MPT, CSCS 
 PT25198 for State of CA 
 E lectronically Signed b y Chris Stempson, MP,TCSCS on 2020-26-12 at 7:41 am 
 005043 
 0503 
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