MEDICARE: DR. JACQUELINE TERESE ORAM PT, DPT, ACSM EP-C

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	225100000X	Physical Therapist	24999	MA

General Provider Information

NPI Number	:	1700492386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUELINE TERESE ORAM PT, DPT, ACSM EP-C

Provider Business Mailing Address
First Line	:	81 BEDFORD ST
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02420-4327
Country	:	US
Telephone Number	:	339-223-4025
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 MAIN ST STE 201
Second Line	:
City	:	NORTH ANDOVER
State	:	MA
Zip	:	01845-2587
Country	:	US
Telephone Number	:	978-315-2500
Fax Number	:

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

Provider Enumeration Date	:	09/19/2020
Last Update Date	:	09/19/2020

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