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Individual

JOHN CLAYTON ZIMBARDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2805 5TH ST, RAPID CITY, SD 57701-6003
(605) 755-5700
Mailing address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(805) 630-0816

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1308
SD
363AS0400X
Surgical Physician Assistant
1308
SD

Other

Enumeration date
08/20/2019
Last updated
11/29/2024
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