DR. Shannon L W Clark Leitenbauer, OD

NPI #1760401632 in Fort Pierce, Florida

Provider Information

NPI Number: 1760401632
Entity Type: Individual
Name: DR. Shannon L W Clark Leitenbauer, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Jul 19, 2006
Last Updated: Jul 29, 2008

Practice Location

Address: 2305 OLEANDER BLVD
City: Fort Pierce
State: Florida
ZIP Code: 34982-5830
Phone: (772) 465-6616

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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