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General NPI Number Information
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NPI Number | 1376425660
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Entity Type | Organization
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Legal Business Name | PACIFIC MYOFASCIAL RELEASE LLC
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 533 AIRPORT BLVD FL 4
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City | BURLINGAME
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State | CA
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Zip | 94010-2013
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Country | US
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Telephone | 650-548-2551
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Fax |
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Provider Business Mailing Address
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Address Line | 533 AIRPORT BLVD FL 4
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City | BURLINGAME
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State | CA
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Zip | 94010-2013
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/MYOFASCIAL RELEASE THERAPIST
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Name | KRISTIN KUNZELMAN
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Credential | CMT
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Telephone | 650-548-2551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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