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Organization
LAKESIDE ORTHOPEDIC INSTITUTE LLC
Active
Organization
LAKESIDE ORTHOPEDIC INSTITUTE LLC
Active
Other names
Lakeside Mobile Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL EDWARD HEINER (AUTHORIZED OFFICIAL)
(928) 505-5555
Entity
Organization
Contact information
Practice address
25 RIVIERA BLVD, LAKE HAVASU CITY, AZ 86403-5694
(928) 505-5555
Mailing address
25 RIVIERA BLVD, LAKE HAVASU CITY, AZ 86403-5694
(928) 505-5555
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
08/23/2021
Last updated
04/22/2026
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