Healthcare Provider Details

I. General information

NPI: 1306289855
Provider Name (Legal Business Name): IWALANI M CRUSH PT, DPT, PRPC, CSC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PELVIC GUIDE LLC

II. Dates (important events)

Enumeration Date: 04/15/2013
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 W SPRINGFIELD RD
SPRINGFIELD PA
19064-1222
US

IV. Provider business mailing address

1 MOORE CIR
MEDIA PA
19063-4953
US

V. Phone/Fax

Practice location:
  • Phone: 484-841-8117
  • Fax: 888-892-3138
Mailing address:
  • Phone: 808-561-2266
  • Fax: 888-892-3138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number032119
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT028288
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberDAPT004698
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberPT028288
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberDAPT004698
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number032119
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: