IndividualActive
Tara Wise, M.S., O.T.R./L
NPI 1851675219 · Military Health Care Provider · Fort Drum, NY
Provider details
- NPI number
- 1851675219
- Entity type
- Individual
- Primary specialty
- Military Health Care ProviderOther Service Providers
- Credential
- M.S., O.T.R./L
- Sex
- Female
- Sole proprietor
- No
- License
- 016540-1 (NY)
Specialties & taxonomies
Other Service Providers
Practice location
11050 Mount Belvedere Blvd
Fort Drum, NY 13602-5438
Phone: (315) 772-3380
Approximate (ZIP-level) locationGet directions
Mailing address
11050 Mount Belvedere Blvd
Fort Drum, NY 13602-5438
Registry dates
- Enumerated
- 2011-10-04
- Last updated
- 2011-10-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.