Individual
MACKENZIE BLAINE CANON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
204 NARROWS RD, SHELBYVILLE, TN 37160-5008
(931) 808-1540
Mailing address
204 NARROWS RD, SHELBYVILLE, TN 37160-5008
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
TN
Other
Enumeration date
01/20/2026
Last updated
01/20/2026
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