Organization
PIONEER SPORTS & PAIN CENTER LLC
Active
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
225100000X
Physical Therapist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
12/17/2010
Last updated
08/24/2026
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