Healthcare Provider Details
I. General information
NPI: 1457032708
Provider Name (Legal Business Name): A3 PHYSICAL THERAPY AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/28/2023
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 E MERMAID LN
GLENSIDE PA
19038-7600
US
IV. Provider business mailing address
5421 QUENTIN ST
PHILADELPHIA PA
19128-2818
US
V. Phone/Fax
- Phone: 610-579-1022
- Fax: 484-245-5370
- Phone: 610-579-1022
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MATTHEW
JOSEPH
CAPPELLI
Title or Position: OWNER
Credential:
Phone: 610-579-1022