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Organization

PIONEER SPORTS & PAIN CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHEN KYLE BURTENSHAW (OWNER)
(208) 922-4908
Entity
Organization

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
111NR0400X
Rehabilitation Chiropractor
Primary
CHIA-1159
ID

Other

Enumeration date
12/17/2010
Last updated
09/11/2025
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