Organization
CAPITOL SURGERY CENTER LLC
Active
Other names
Waverly Lake Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER D KOLB (ADMINISTRATOR)
(541) 918-4210
Entity
Organization
Contact information
Practice address
633 WAVERLY DR SE, ALBANY, OR 97322-5078
(541) 918-4210
(541) 918-4215
Mailing address
633 WAVERLY DR SE, ALBANY, OR 97322-5078
(541) 918-4210
(541) 918-4215
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
07/02/2009
Last updated
12/16/2021
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