Organization
DLC DELTA, INC.
Active
Other names
Orthogenetics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD MASTAW MD (INTERIM CEO)
(734) 389-5832
Entity
Organization
Contact information
Practice address
259 S E ST, PENSACOLA, FL 32502-4569
(734) 389-5832
Mailing address
259 S E ST, PENSACOLA, FL 32502-4569
(734) 389-5832
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
251B00000X
Case Management Agency
—
—
Other
Enumeration date
05/28/2021
Last updated
05/28/2021
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