Organization
LAKESIDE ORTHOPEDIC INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL EDWARD HEINER MD (AO)
(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
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/13/2024
Last updated
04/22/2026
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