Healthcare Provider Details

I. General information

NPI: 1225175755
Provider Name (Legal Business Name): BLOOMINGTON WELLNESS CENTER, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5143 W 98TH ST
BLOOMINGTON MN
55437-2040
US

IV. Provider business mailing address

5143 W 98TH ST
BLOOMINGTON MN
55437-2040
US

V. Phone/Fax

Practice location:
  • Phone: 952-881-2800
  • Fax: 612-605-2788
Mailing address:
  • Phone: 952-881-2800
  • Fax: 612-605-2788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC3760
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CORY L EMBERLAND
Title or Position: OWNER
Credential: DC
Phone: 952-881-2800