Leitenbauer, Shannon L W Clark
Leitenbauer, Shannon L W Clark is an individual health care provider with primary practice located at 2305 Oleander Blvd , Fort Pierce FL 34982-5830. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Leitenbauer, Shannon L W Clark can be contacted via phone (772) 465-6616.Contact Information
Primary practice address
2305 Oleander Blvd
Fort Pierce FL 34982-5830
Phone: (772) 465-6616
Fax: (772) 468-2858
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPC0003067 | Florida |
Profile Details
| NPI number | 1760401632 |
|---|---|
| LBN Legal business name | Leitenbauer, Shannon L W Clark |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2006 |
| Last updated | Jul 29th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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