Individual
MACKENZIE BLOXHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAT, LAT, ATC
Contact information
Practice address
1 WILLIAM L JONES DR, COOKEVILLE, TN 38505-0001
(931) 372-3101
Mailing address
75 E VETERANS DR APT B101, COOKEVILLE, TN 38501-4699
(435) 512-0372
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000051989
UT
Other
Enumeration date
01/09/2025
Last updated
01/09/2025
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