Jaime Lee

 
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 Tow er Physical Therapy, Inc. 
 Patient N ame:Jaime Lee
 1471 Colorado Ave, Suite 470 
 Patient # :347805 
 Turlock, CA 47382-4700 
 Phone: (247)476-4760 
 Daily N ote / 
 BIRTHDATE: 89/07/07
 Document Date: 22/10/13
 Fax: (247)247-3475 
 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 23/04/02 at 2:51 am 
 004743 
 0473 
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