IndividualActive
Bruce Mcclellan, C.P.O.
NPI 1104976182 · Orthotist · Tyler, TX
Provider details
- NPI number
- 1104976182
- Entity type
- Individual
- Primary specialty
- OrthotistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- C.P.O.
- Sex
- Male
- Sole proprietor
- No
- License
- 25 (TX)
Practice location
1122 E Front St
Tyler, TX 75702-8414
Phone: (903) 592-6574
Fax: (903) 595-3862
Mailing address
1122 E Front St
Tyler, TX 75702-8414
Registry dates
- Enumerated
- 2007-01-11
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.