person
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. You can also correspond with Tara E Wise through the mailing address at 11050 MOUNT BELVEDERE BLVD, FORT DRUM, NY - 13602-5438 (mailing address contact number: 315-772-3380).

Location: 11050 Mount Belvedere Blvd, Fort Drum, NY, 13602-5438
person
Provider Profile Details
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
institution
Provider Business Practice Location Address Details
Address
11050 Mount Belvedere Blvd
City
State
Zip
13602-5438
Phone Number
315-772-3380
Fax Number
person
Provider Business Mailing Address Details
Address
11050 Mount Belvedere Blvd
City
State
Zip
13602-5438
Phone Number
315-772-3380
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
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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