Organization
MODERN CONCEPTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYN KNIGHT (OFFICE MANAGER)
(803) 802-2225
Entity
Organization
Contact information
Practice address
1808 SECOND BAXTER XING STE 108, FORT MILL, SC 29708
(803) 802-2225
Mailing address
1808 SECOND BAXTER XING STE 108, FORT MILL, SC 29708-6437
(803) 802-2225
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/21/2017
Last updated
06/28/2018
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