Individual
GREG T BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSPT
Contact information
Practice address
353 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4936
(401) 751-6900
(401) 751-6902
Mailing address
353 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4936
(401) 751-6900
(401) 751-6902
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT00008306
WA
225100000X
Physical Therapist
Primary
PT02476
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142702
DEPT OF LABOR & INDUSTRIE
WA
01
—
4423BU
REGENCE BLUE SHIELD
WA
01
—
650019911
RAILROAD MEDICARE
WA
05
—
8334492
—
WA
01
—
8935159
CRIME VICTIMS
WA
Enumeration date
04/28/2006
Last updated
12/09/2025
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