Individual
SHANNON MARIE LEONARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
170 S INDEPENDENCE MALL W STE 210W, PHILADELPHIA, PA 19106-3325
(215) 925-6402
(215) 925-0262
Mailing address
170 S INDEPENDENCE MALL W STE 210W, PHILADELPHIA, PA 19106-3325
(215) 925-6402
(215) 925-0262
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
270A00708200
NJ
152W00000X
Optometrist
Primary
OEG003991
PA
Other
Enumeration date
08/16/2021
Last updated
09/01/2023
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