Provider Demographics
NPI:1356621270
Name:TWIN CITIES SCOLIOSIS CENTER, LLC
Entity type:Organization
Organization Name:TWIN CITIES SCOLIOSIS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CORY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:EMBERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-881-2800
Mailing Address - Street 1:5300 HYLAND GREENS DR
Mailing Address - Street 2:#110
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437-3933
Mailing Address - Country:US
Mailing Address - Phone:952-881-2800
Mailing Address - Fax:
Practice Address - Street 1:5300 HYLAND GREENS DR
Practice Address - Street 2:#110
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437-3933
Practice Address - Country:US
Practice Address - Phone:952-881-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3760261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center