Healthcare Provider Details

I. General information

NPI: 1891602413
Provider Name (Legal Business Name): MICHAELA OBERMARK PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10800 FARLEY ST STE 13
OVERLAND PARK KS
66210-1414
US

IV. Provider business mailing address

7813 N EUCLID AVE
KANSAS CITY MO
64118-2062
US

V. Phone/Fax

Practice location:
  • Phone: 913-681-0606
  • Fax:
Mailing address:
  • Phone: 816-642-6451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2026029004
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: