Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shannon L Clark O D P A

Organization Eyewear Supplier · NPI 1770767733

Shannon L Clark O D P A is an Eyewear Supplier in Fort Pierce, Florida. Licensed in Florida. Registered with an NPI since 2007.

Licensed in
FL
In the registry since
2007
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Practice location Address checks out

2305 Oleander Blvd
Fort Pierce, FL 34982-5830
Phone: (772) 465-6616
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Eyewear Supplier (primary) Taxonomy 332H00000X · Licence OPC 0003067 (FL)

Record details

NPI number1770767733
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shannon Clark Leitenbauer — President/Owner · (772) 465-6616
NPI enumeratedDecember 26, 2007
Last updated in NPPESJuly 29, 2008
Mailing address2305 Oleander Blvd, Fort Pierce, FL 34982-5830

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