Individual
VINCENT L MODERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
143 COPPERSMITH DR, LEXINGTON, SC 29073-9847
(616) 886-5276
Mailing address
143 COPPERSMITH DR, LEXINGTON, SC 29073-9847
(616) 886-5276
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
SC
Other
Enumeration date
09/22/2025
Last updated
09/22/2025
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