Provider Demographics
NPI:1376425660
Name:PACIFIC MYOFASCIAL RELEASE LLC
Entity type:Organization
Organization Name:PACIFIC MYOFASCIAL RELEASE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MYOFASCIAL RELEASE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNZELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CMT
Authorized Official - Phone:650-548-2551
Mailing Address - Street 1:533 AIRPORT BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-2013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:533 AIRPORT BLVD FL 4
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-2013
Practice Address - Country:US
Practice Address - Phone:650-548-2551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty