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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