MATTHEW BRUCE MCCLELLAN

TYLER, TX
NPI1073134177
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224P00000X Prosthetist
(Licence: TX  2047)
Additional Taxonomies222Z00000X Orthotist
(Licence: TX  2047)
Enumeration Date2020-04-29
Last Update Date2020-04-29
Business Address
MATTHEW BRUCE MCCLELLAN C.P.O.
1122 E FRONT ST
TYLER, TX 75702-8414
Phone number: 903-592-6574
Mailing Address
MATTHEW BRUCE MCCLELLAN C.P.O.
1122 E FRONT ST
TYLER, TX 75702-8414
Phone number: 903-592-6574