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General NPI Number Information
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NPI Number | 1780469189
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Entity Type | Individual
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Provider Name | MICHAEL BURGESS PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 08/25/2023
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 52 BEAR DR STE B
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City | GREENVILLE
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State | SC
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Zip | 29605-4458
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Country | US
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Telephone | 864-900-9342
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Fax |
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Provider Business Mailing Address
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Address Line | 3280 MANNING HWY
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City | GREELEYVILLE
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State | SC
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Zip | 29056-8823
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Country | US
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Telephone | 843-372-9600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | P22602
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 12552PT
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License Number State | SC
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