Healthcare Provider Details

I. General information

NPI: 1881560241
Provider Name (Legal Business Name): HAZEL PHYSICAL THERAPY AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4522 BALTIMORE AVE FL 2
PHILADELPHIA PA
19143-3705
US

IV. Provider business mailing address

4723 HAZEL AVE
PHILADELPHIA PA
19143-2022
US

V. Phone/Fax

Practice location:
  • Phone: 215-315-3063
  • Fax:
Mailing address:
  • Phone: 215-315-3063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JOANNA HESS
Title or Position: OWNER
Credential: PT, DPT, PRC, WCS
Phone: 215-315-3063