Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Douglas Bruce Wyatt

Individual provider Physical Therapist · NPI 1174094437

Douglas Bruce Wyatt is a Physical Therapist in Private Practice in Ann Arbor, Michigan. Qualified in 2016, 10 years ago. Practices with Athletico Ltd, a 2,186-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
10
Licensed in
MI
In the registry since
2018
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Practice location Address checks out

2570 Jackson Ave Ste C
Ann Arbor, MI 48103-3853
Phone: (734) 823-7820
Fax: (734) 823-7821
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 5501018165 (MI)

Record details

NPI number1174094437
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 16, 2018
Last updated in NPPESSeptember 12, 2025
Certification dateSeptember 12, 2025
Mailing address2122 York Rd Ste 300, Oak Brook, IL 60523-1925

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Athletico Ltd — 2186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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