Organization
LAKESIDE ORTHOPEDIC INSTITUTE LLC
Active
Organization
LAKESIDE ORTHOPEDIC INSTITUTE LLC
Active
Other names
Lakeside CT
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL EDWARD HEINER MD (MD/PARTNER)
(928) 505-5555
Entity
Organization
Contact information
Practice address
1944 MESQUITE AVE, LAKE HAVASU CITY, AZ 86403-5729
(928) 505-5555
Mailing address
25 RIVIERA BLVD, LAKE HAVASU CITY, AZ 86403-5694
(928) 505-5555
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
01/21/2025
Last updated
01/21/2025
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