Shannon D. Fowler, Od, PA

NPI #1902088677 in Destin, Florida

Provider Information

NPI Number: 1902088677
Entity Type: Organization
Organization Name: Shannon D. Fowler, Od, PA
Primary Specialty: Optometrist
Enumeration Date: Dec 4, 2007
Last Updated: Mar 16, 2010

Practice Location

Address: 4418 COMMONS DR E
Address 2: STE A
City: Destin
State: Florida
ZIP Code: 32541-8406
Phone: (850) 654-3937

Authorized Official

Name: DR. SHANNON FOWLER, O.D.
Title: PRESIDENT
Phone: (850) 654-3937

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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