| NPI | 1548936164 |
|---|---|
| Doing Business As | LAKESIDE MOBILE IMAGING |
| Entity Type | Organization |
| Authorized Contact | DANIEL EDWARD HEINER Authorized Official 928-505-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0208X Clinic/Center Radiology, Mobile |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2023-06-08 |