Organization
LAKESIDE PHYSICAL THERAPY, REHAB & SPORTS MEDICINE
Active
Other names
Lakeside Orthopedic Institute
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA HORTON (OFFICE MANAGER)
(928) 855-4248
Entity
Organization
Contact information
Practice address
25 RIVIERA BLVD, LAKE HAVASU CITY, AZ 86403-5694
(928) 505-5555
Mailing address
1791 MESQUITE AVE, LAKE HAVASU CITY, AZ 86403-5648
(928) 855-4248
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1448
AZ
Other
Enumeration date
02/12/2016
Last updated
02/12/2016
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