Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lakeside Orthopedic Institute, LLC

Organization Physical Therapist · NPI 1962636050

Lakeside Orthopedic Institute, LLC provides Physical Therapist services in Lake Havasu City, Arizona. Licensed in Arizona. Registered with an NPI since 2009.

Licensed in
AZ
In the registry since
2009
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1979 McCulloch Blvd N Ste 101
Lake Havasu City, AZ 86403-0953 Not confirmed with CMS for 17 years — call before visiting
Phone: (928) 855-4842
Fax: (928) 855-7452
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2641 (AZ)
Physical Therapist Taxonomy 225100000X · Licence 8192 (AZ)
Physical Therapist Taxonomy 225100000X · Licence 6762 (AZ)

Record details

NPI number1962636050
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wesley Johnson — President · 92885455555
NPI enumeratedMay 5, 2009
Last updated in NPPESMay 5, 2009
Mailing address25 Riviera Blvd, Lake Havasu City, AZ 86403-5694

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