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

Individual provider Physical Therapist · NPI 1679010177

Lucas Jacob Vanderlaan, PHYSICALTHERAPIST is a Physical Therapist in Private Practice in Berkley, Michigan. Qualified in 2016, 10 years ago. Practices with Orthosport Physical Therapy and Athletic Rehabilitation Inc, a 5-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
10
Licensed in
MI
In the registry since
2017
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Practice location Address checks out

28933 Woodward Ave
Berkley, MI 48072-0923
Phone: (248) 414-7592
Fax: (248) 414-7661
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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 5501018017 (MI)

Record details

NPI number1679010177
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICALTHERAPIST
Sole proprietorNo
NPI enumeratedJanuary 23, 2017
Last updated in NPPESJanuary 23, 2017

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 Orthosport Physical Therapy And Athletic Rehabilitation Inc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Berkley