Saturday, June 10, 2017

Broken Nose Mask: Hoosier Madrid Model Soccer Mask #6401 to Marne in Wes...

Madrd Mask #6401 to Marne / West Haven, UT
Website Order Taken : 6/05/17 @ 12:51PM Shipped: 5/29/17 @ 5:00 PM
Carrier: FedEx 2nd Day Air
PA: Marne W's (son)/West Haven, UT
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 recent soccer match.
Plan: Custom-fabricate Madrid model (color: black) #6401
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.
SKU: madrid#6401
Country of Origin: Made in USA / Indianapolis, IN by Clyde Peach, CO
Sport: soccer
ABC Certified
User Comments: male 5'3 1/2" 110 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 and Prosthetics

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