Healthcare Provider Details

I. General information

NPI: 1174431670
Provider Name (Legal Business Name): BLOOMING WELLNESS CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7860 VINEWOOD LN STE 32
MAPLE GROVE MN
55369-7058
US

IV. Provider business mailing address

7860 VINEWOOD LN STE 32
MAPLE GROVE MN
55369-7058
US

V. Phone/Fax

Practice location:
  • Phone: 715-323-6973
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GRACE MARIE WENDELS
Title or Position: DOCTOR/OWNER
Credential: DC
Phone: 715-323-6973