Broken Nose: Madrid Mask #6358 to William in Mechanicsville, VA

Website Order Taken : 5/09/17 @ 10:13 PM PM Shipped: 5/11/17 @ 5:00 PM UPS Ground
PA: WilliamA.(daughter)/Mechanicsville, VA
RX: Protective Mask for Broken Nose - Madrid Model
DX: Fractures of Nasal Bones
ICD-10-CM Diagnosis Code: S02 2XXB
HX: Athlete has sustained nasal fracture during a soccer.

William's Daughters Madrid Soccer Mask

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.
Sport: soccer
User Comments: female 5'5" 120 lbs
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