| Modern Concepts, Llc | |
|
1808 Second Baxter Xing Ste 108 Fort Mill SC 29708 | |
| (803) 802-2225 | |
| Not Available |
| Full Name | Modern Concepts, Llc |
|---|---|
| Speciality | General Practice |
| Location | 1808 Second Baxter Xing Ste 108, Fort Mill, South Carolina |
| Authorized Official Name and Position | Robyn Knight (OFFICE MANAGER) |
| Authorized Official Contact | 8038022225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Concepts, Llc 1808 Second Baxter Xing Ste 108 Fort Mill SC 29708-6437 Ph: (803) 802-2225 | Modern Concepts, Llc 1808 Second Baxter Xing Ste 108 Fort Mill SC 29708 Ph: (803) 802-2225 |
| NPI Number | 1841704244 |
|---|---|
| Provider Enumeration Date | 11/21/2017 |
| Last Update Date | 06/28/2018 |
| Medicare PECOS PAC ID | 9739427121 |
|---|---|
| Medicare Enrollment ID | O20190211000084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841704244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Luke F Mackinnon |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1336116649 PECOS PAC ID: 4385795814 Enrollment ID: I20090624000056 |
| Provider Name | Miles T Dowswell |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1487876454 PECOS PAC ID: 9436170800 Enrollment ID: I20191105001520 |
| Provider Name | Jeremy Lynn Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568942696 PECOS PAC ID: 5597007799 Enrollment ID: I20200519000616 |
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