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

Pinetop-Lakeside Integrative & Physical Medicine, LLC

Organization Physical Medicine & Rehabilitation Physician · NPI 1376864462

Pinetop-Lakeside Integrative & Physical Medicine, LLC is a Physical Medicine & Rehabilitation Physician in Lakeside, Arizona. Licensed in Arizona. Registered with an NPI since 2010.

Licensed in
AZ
In the registry since
2010
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1628 Reed Ln
Lakeside, AZ 85929-6983
Phone: (928) 358-1648
Fax: (928) 368-5178
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pain Medicine (Physical Medicine & Rehabilitation) Physician (primary) Taxonomy 2081P2900X · Licence 34673 (AZ)
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X · Licence 34673 (AZ)

Record details

NPI number1376864462
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kevin Mar — Manager · (928) 358-1648
NPI enumeratedJune 13, 2010
Last updated in NPPESJune 13, 2010
Mailing address1628 Reed Ln, Lakeside, AZ 85929-6983