MEDICARE: BLOOMINGTON WELLNESS CENTER, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QX0100X	Occupational Medicine Clinic/Center
2	261Q00000X	Clinic/Center
3	111N00000X	Chiropractor	DC3760	MN

General Provider Information

NPI Number	:	1225175755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOMINGTON WELLNESS CENTER, PA

Provider Business Mailing Address
First Line	:	5143 W 98TH ST
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55437-2040
Country	:	US
Telephone Number	:	952-881-2800
Fax Number	:	612-605-2788

Provider Business Practice Location Address
First Line	:	5143 W 98TH ST
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55437-2040
Country	:	US
Telephone Number	:	952-881-2800
Fax Number	:	612-605-2788

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CORY L EMBERLAND
Credential	:	DC
Telephone Number	:	952-881-2800

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	12/09/2025

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