Broken Nose Mask: Madrid Soccer Mask to James in Massapequa, NY 5/28/17

Website STAT Order Taken : 5/28/17 @ 2:55 PM Shipped: 5/29/17 @ 5:00 PM UPS 2nd Day Air
PA: James M.'s (son)/Massapequa, NY
RX: Protective Mask for Broken Nose - Madrid Soccer Model
DX: Fractures of Nasal Bones

James's Madrid Soccer Mask / Son's Broken Nose

ICD-10-CM Diagnosis Code: S02 2XXB
HX: Athlete has sustained nasal fracture during a soccer match.
Plan: Custom-fabricate Madrid model (color: black) using shatter proof LDP that will not re-injure recent fractures, will shape to face naturally and avoid eye injuries. Customize design for maximum nasal protection and minimum obstruction of peripheral and downward vision. Low profile design to allow for headers both side and front. Add gentle moleskin felt contact bumper pads internally for comfort.
Country of Origin: Made in USA / Indianapolis, IN
Sport: soccer
User Comments: male 5'8 1/2" 152 lbs / This is for my son. Please call me if the STAT order and this shipping will not get to me by Friday 6/2/17 -big match.Website: www.indianabrace.com
Practitioner: Clyde Peach, CO - ABC Certified Orthotist #1321 - 1979
Contact: Call: 800.253.6217 Text: 317.445.1475
Email: clyde.peach@indianabrace.com
American Board for Certification in Orthotics and Prosthetics