Healthcare Provider Details

I. General information

NPI: 1356264972
Provider Name (Legal Business Name): THE PELVIC PLACE KC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S JEFFERSON ST STE B6
KEARNEY MO
64060-8833
US

IV. Provider business mailing address

6011 N BALES AVE
KANSAS CITY MO
64119-1935
US

V. Phone/Fax

Practice location:
  • Phone: 816-977-3870
  • Fax:
Mailing address:
  • Phone: 816-977-3870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAELA LUPO
Title or Position: DOCTOR OF PHYSICAL THERAPY
Credential: DPT
Phone: 816-977-3870