Therapist Name: Allison Wierda
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Patient Name: Jan Thomas §°86b: 311960 of Oe Fm?
Date of Service: 25019 fo Aetmte Noled
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PT Diagnosis (ICD-10). M7542 (L shoulder impingement) l> Guat ib |
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Medical Diagnosis (ICD-10): M25.512 (L shoulder pain)
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