Broken Nose Mask / Clyde's Madrid Mask to Marina in Glendale, CA

Published on Mar 21, 2017

Website Order Taken : 3/18/17 @ 4:24 PM Shipped: 3/19/17 @ 5:00 PM USPS Priority Mail
PA: Marina K.'s (daughter) /Glendale, CA
RX: Protective Mask for Broken Noses
DX: Fractures of Nasal Bones
ICD-10-CM Diagnosis Code: S02 2XXA
HX: Athlete has sustained nasal fracture during various contact sports
O&P Plan: Custom-fabricate Madrid model (color: clear) using shatter proof DuPont
Surlyn 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.
Add gentle moleskin contact bumper pads internally for comfort.
Sport: basketball
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@gmail.com
American Board for Certification in Orthotics & Prosthetics