Individual
ZACKERY J CLEVERLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
360 E MAIN ST, REXBURG, ID 83440-2015
(208) 356-9550
(208) 356-8023
Mailing address
360 E MAIN ST, REXBURG, ID 83440-2015
(208) 356-9550
(208) 356-8023
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
PA-1527
ID
Other
Enumeration date
09/27/2017
Last updated
02/02/2026
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