Healthcare Provider Details

I. General information

NPI: 1417708314
Provider Name (Legal Business Name): JESSICA CREAMER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA ORAM DPT

II. Dates (important events)

Enumeration Date: 03/28/2024
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4925 GRANDE DR
PENSACOLA FL
32504-8965
US

IV. Provider business mailing address

9168 QUAIL ROOST DR
NAVARRE FL
32566-1182
US

V. Phone/Fax

Practice location:
  • Phone: 850-746-4901
  • Fax: 850-746-4903
Mailing address:
  • Phone: 850-512-8978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT34902
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: