Provider Demographics
NPI:1316812993
Name:PELVIC GUIDE LLC
Entity type:Organization
Organization Name:PELVIC GUIDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:IWALANI
Authorized Official - Middle Name:M
Authorized Official - Last Name:CRUSH
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, PRPC, CSC
Authorized Official - Phone:484-841-8177
Mailing Address - Street 1:1 MOORE CIR
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-4953
Mailing Address - Country:US
Mailing Address - Phone:484-841-8177
Mailing Address - Fax:
Practice Address - Street 1:816 W SPRINGFIELD RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-1222
Practice Address - Country:US
Practice Address - Phone:484-841-8177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty