Individual
DEVON LATEZ BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1672 N MAIN ST STE 11, SUMMERVILLE, SC 29486-7811
(843) 289-1456
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 702-4389
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
12957
SC
225100000X
Physical Therapist
CP042126T
SC
225100000X
Physical Therapist
Primary
CP053410T
SC
225100000X
Physical Therapist
PT016568
GA
Other
Enumeration date
06/09/2023
Last updated
06/08/2026
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