Organization
MK GLAM RX
Active
Organization
MK GLAM RX
Active
Parent organization
MK GLAM LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MK GLAM LLC
Authorized official
MAEYONNI WESTBROOK (OWNER)
(215) 609-2907
Entity
Organization
Contact information
Practice address
2290 W OREGON AVE # 1026, PHILADELPHIA, PA 19145-4197
(267) 399-0081
Mailing address
2290 W OREGON AVE # 1026, PHILADELPHIA, PA 19145-4197
(267) 399-0081
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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