MEDICARE: ANNA WEBSTER BURGESS PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251N0400X	Neurology Physical Therapist	P23473	NC
2	2251S0007X	Sports Physical Therapist	P23473	NC
3	2251X0800X	Orthopedic Physical Therapist	P23473	NC
4	225100000X	Physical Therapist	CP033394T	SC

General Provider Information

NPI Number	:	1740013937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA WEBSTER BURGESS PT, DPT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-497-0005
Fax Number	:

Provider Business Practice Location Address
First Line	:	1017 FORDING ISLAND RD # F-101
Second Line	:
City	:	BLUFFTON
State	:	SC
Zip	:	29910-4211
Country	:	US
Telephone Number	:	843-815-2563
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2024
Last Update Date	:	11/25/2024

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