Individual
DR. STEPHEN KYLE BURTENSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
757 E WYTHE CREEK CT STE 102, KUNA, ID 83634-5006
(208) 922-4908
(208) 922-4909
Mailing address
757 E WYTHE CREEK CT STE 102, KUNA, ID 83634-5006
(208) 922-4908
(208) 922-4909
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1159
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807407200
—
ID
Enumeration date
08/03/2006
Last updated
09/29/2021
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