Rachel Duffy

 Patient: 
 Rachel Duffy
 NSPT, 
 Acct #: 79864 
 BIRTHDATE: 
 02/04/1998
 Visiting Date: 05/05/2020 
 Physician: Dr Robert Collins 
 Phys Phone: 602-611-5424 
 north Salinaa Physical 
 Phys Fax: 160-958-8716 
 SSN: XXX-XX-XXXX 
 Inj. Date: 
 01/09/2017 
 1758 N. Main Street 
 Clinician: Chris Temple 
 Salinas, CA, USA, 93906 
 Visits: 
 2 
 Phone: (831) 442-3700 
 Case Mgr: 
 Cxl/Ns: 
 0 
 Fax: (831) 442-3711 
 Payor: 
 MEDRISK 
 Daily Note 
 Diagnosis 
 Left 
 S39.064D 
 Strain of muscle, fascia and tendon of 
 Spine 
 lower back, subsequent encounter 
 General Information 
 This 72 y.o. female presents with complaints of L sided low back pain after straining it while pulling a box at work (12/7/21). 
 Document ID: 002031CA.003 
 Status: Signed off (secure electronic signature) 
 Page 1 of 2 
 Sean Lauer,Lic Applicant PTA; Chris Temple,PT(CA Lic: 294639) 
 97
