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Organization

BSM SURGERY CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER DAWN KOLB (MANAGER)
(541) 268-4641
Entity
Organization

Contact information

Practice address
1128 NE SECOND STREET, SUITE 104, CORVALLIS, OR 97330-6293
(541) 207-3334
(541) 207-3231
Mailing address
1128 NE SECOND STREET, SUITE 104, CORVALLIS, OR 97330-6293
(541) 207-3334
(541) 207-3231

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500639211
OR
05
PENDING
OR
Enumeration date
06/04/2009
Last updated
09/18/2015
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