Tara E Wise, MS, OTR/L - Fort Drum, NY

Tara E Wise, MS,OTR/L

Military Health Care Provider in Fort Drum, New York

NPI 1851675219

Tara E Wise is a Military Health Care Provider based in Fort Drum, NY. Tara E Wise practices in Fort Drum, NY and has the professional credentials of MS,OTR/L. The NPI Number for Tara E Wise is 1851675219 and holds a License No. 016540-1 (New York).

The current practice location address for Tara E Wise is 11050 Mount Belvedere Blvd, Fort Drum, NY and can be reached out via phone at 315-772-3380.

Location: 11050 Mount Belvedere Blvd, Fort Drum, NY, 13602-5438

NPI Number

1851675219

Provider Name

Tara E Wise

Credential

MS,OTR/L

Provider Entity Type

Individual

Gender

Female

Address

11050 Mount Belvedere Blvd, Fort Drum, NY, 13602-5438

Phone Number

315-772-3380

Fax Number

Provider Enumeration Date

10/04/2011

Last Update Date

03/09/2024

Address

11050 Mount Belvedere Blvd

City

Fort Drum

State

New York

Zip

13602-5438

Phone Number

315-772-3380

Fax Number

Address

11050 Mount Belvedere Blvd

City

Fort Drum

State

New York

Zip

13602-5438

Phone Number

315-772-3380

Fax Number

Type

Other Service Providers

Classification

Military Health Care Provider

Speciality

Taxonomy

171000000X

License No.

016540-1 (New York)

Definition

Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.

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