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General NPI Number Information
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NPI Number | 1881551067
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Entity Type | Organization
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Legal Business Name | PACIFIC HEALTHLINE PLLC
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 1501 S FIVE MILE RD
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City | BOISE
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State | ID
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Zip | 83709-1374
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Country | US
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Telephone | 208-322-1008
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Fax | 844-647-2550
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Provider Business Mailing Address
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Address Line | 11078 W TIOGA ST
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City | BOISE
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State | ID
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Zip | 83709-3341
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Country | US
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Telephone | 208-935-5074
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Fax | 844-647-2550
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Authorized Official
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Title or Position | DOCTOR OF PHYSICAL THERAPY
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Name | KYNDAHL MARIE BRUNER
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Credential | DPT
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Telephone | 208-935-5074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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